ABSTRACT
The value-stream mapping event identified several opportunities for improvement including the lack of a standardized leadership response to throughput issues. Emergency Department (ED) divert was most frequently staff-invoked when staff believed they were overloaded. A kaizen team, comprised of executives and directors, was formed to define the desired leadership response to divert. The kaizen team designed an “ideal state” process flow incorporating the Lean tools necessary to support an average takt time of 60 minutes utilizing three newly designed fast track rooms. In preparation for the no-divert policy implementation, a further redesign was undertaken in triage that resulted in a major shift in patient assessment. Sustainment is an ongoing challenge. Weekly meetings of the ED value-stream team included ED leadership, staff, and providers, along with ancillary department representatives. The ED had traditionally requested a bed once the patient was ready to move to the unit.
