Improvement through Small Cycles of Change: Lessons from an Academic Medical Center Emergency Department

Publication Date

2017

Journal Title

J Healthc Qual

Abstract

This article describes the experiences of a quality improvement team that used small cycles of change to improve the emergency department (ED) of an academic medical center. The role of EDs in the provision of healthcare continues to increase in importance. ED bottlenecks contribute to long waits and diminished outcomes for ED patients as well as more system-wide issues, such as inefficiencies in inpatient admission processes. The purpose of this "ED Operational Efficiency Project" was to reduce lengths of stay (LOS) for low-acuity patients. The team used lean management techniques to both improve services and shift the ED culture to prioritize continuous quality improvement. The goal to reduce LOS by 30% was met as the result of several interrelated projects (or small cycles of change). Key lessons include monitoring metrics, communicating with teams and target populations, learning from initial failures, using small wins to increase momentum, and anchoring changes.

Volume Number

39

Issue Number

5

Pages

259-269

Document Type

Article

EPub Date

2014/10/22

Status

Faculty

Facility

School of Medicine

Primary Department

General Internal Medicine

PMID

28858964

DOI

10.1111/jhq.12078

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