Weekend Services Lean Team
From Business Intelligence
Contents |
[edit] Project Contact
If you have questions or would like more information, please contact Brendon Weil (bweil@med.umich.edu).
[edit] Project Description
The University Hospitals and Health Centers (UMHHC) Weekend Services Lean Team used and married existing and newly mined data sets from Carelink, CareWeb Data Warehouse and other “department specific” information systems to determine if delays in providing services (especially those caused by lower staffing levels on weekends) contributed to higher lengths of stay for adult inpatients. From the completed analysis, the team:
- Discovered reasons behind the statistical differences in length of stay for patients admitted on weekdays versus weekends.
- Used the data to analyze the potential impact of various remedies and determine recommendations.
- Began forming teams for additional analysis and the implementation of solutions.
[edit] Business Need
- Identify reasons for increased lengths of stay patients admitted to the University of Michigan Health System.
[edit] System/Application & Data Sources
The team used data from Carelink, CareWeb Data Warehouse and other “department specific” information systems.
[edit] Project Purpose, Scope, & Deliverables
Research, findings, and results of the Weekend Services Lean Team efforts to reduce patient length of stay included:
- Patients of certain diagnosis-related groups (DRGs) had significantly greater lengths of stay when they were admitted on Friday as opposed to Monday. Research suggested that this phenomenon occurred because many critical hospital services were in short supply or completely unavailable to deliver care on the weekend.
- Analysis of the scheduled availability of 27 different services for each day of the week showed that average staffing for Faculty Dependent Services decreased 80% weekday to weekend and Non-Faculty Dependent Services fell 61% weekday to weekend. The team calculated that the Hospital Patient Census dropped only 4% on the weeked.
- The team identified 16 services and scenarios to analyze further with a goal of determining which ones led to the greatest increase in patient length of stay.
- A full picture of patients' stays were obtained from combined data files from Carelink, CareWeb, Data Warehouse and other "department specific" information systems.
- Detailed analysis disclosed that 9 of the 16 services showed higher lengths of stay when the patient was admitted on the weekend (Fri. Sat. Sun.) versus weekdays. Four of these areas, Practice Management/Discharge Planning, Echocardiography, Physical Therapy and Occupational Therapy had a large enough impact to warrant further analysis into response times and other contributing factors unique to that service. This data showed that new orders, especially those arriving soon after a patient was admitted, were not or were seldom addressed by those four services on the weekends, which resulted in higher lengths of stay.
- By linking service delays early in a patient’s visit to increased length of stay, the team established that the initiation of services played as high or higher role as “discharge pending” orders in impacting when a patient goes home. The four process improvement foci, Practice Management/Discharge Planning, Echocardiography, Physical Therapy and Occupational Therapy all had a greater impact on patient throughput when they were able to introduce their service quickly in order to establish diagnostics and plans of care.
- The team is attempting to enable these services to respond as soon as possible in a patient’s stay by reprioritizing work to service new patients first and establish plans of care; changing staffing models to meet demands on the weekends; and increased efficiency through process improvement.
[edit] Audience/Users
Operations in the following UMHHS departments will benefit from this Weekend Services Lean Team project.
- Quality Control
- Practice Management/Discharge Planning
- Echocardiography
- Physical Therapy
- Occupational Therapy
[edit] Project Sponsors/Partners
- Shon Dwyer - Associate Hospital Director