ABSTRACT
The move to the new Emergency Department (ED) was problematic in many respects. The staffing budget, like most hospitals, was based on projected volume; and there was no increased staffing allocation based on the false presumption that “it will never fill up.” In 2002, the ED had implemented an ED information system that had a proficient tracking grid. The vision to become a Lean ED was straightforward. Focus on patient value streams, processes, creating patient value, and becoming a learning organization. The concept of a Super Track was derived as an evolution of the traditional fast track after value-stream mapping identified a significant amount of waste in the traditional system. Job duties were distributed among operators whenever possible. Rapid-cycle testing was utilized to test the future-state design. Several future iterations involved adding a scribe, further off-loading the nurse and doctor in Super Track.
