Emergency Department Revenue Cycle Improvement: A Success Story
Hospital administrators noticed defects in patient medical and registration entries, which led to excessive rework from auxiliary, medical records, and billing department employees.
A group of the hospital’s medical, financial, and stakeholder decision makers worked with Lean Six Sigma experts to set a goal of reducing defects and time spent by 50%. They divided into two teams to separately address 1) registration-related account processing issues and 2) medical information-related account processing issues.
Each team collected data from patient registration and medical information workflows for 5 days. Auxiliary departments (radiology, clinical lab, pharmacy, and respiratory therapy) also tracked information they received from the ER. The data revealed that for every 100 minutes spent processing patient accounts, 55 were for rework. Also, for every 100 patient accounts processed, 75 had defective information, which required rework.
Mapping the Value Stream
Working with Lean Six Sigma experts, the teams developed a Value Stream Map to detail the steps involved in registering a patient, from arriving in the ER to mailing the final bill for services. The Value Stream Map served as a point of reference, helping the teams identify waste, long wait times, and defects in their workflow. They learned the causes of waste were 1) insufficient software training and 2) no established “standard operating procedure” for entering patient data into the software program.
A Clear Solution
The hospital team worked with Lean Six Sigma Experts, as well as the hospital’s technology staff, to create an action plan for developing a software training curriculum and standard operating procedures for employees to follow during registration, billing, and other patient data entries.
Measurable Results
Minutes of rework were reduced by 75% and the number of defects was reduced more than threefold. As a direct result of these Lean Six Sigma improvements, the hospital saved more than $175,000 in soft dollars or productivity. Further, updates to medical records, which used to take three days, now took only one. This greatly improved quality of care for patients who required follow-up treatment after the ER. This project also led to the formation of a software information team of nurses to address changing medical codes and software applications on a regular basis.
Doing More with Less
Hospitals and clinical health care settings can reap big rewards from a wide variety of projects. Lean Six Sigma is especially helpful for those ongoing, hard-to-diagnose problems that whittle away at hospital revenue, patient care performance, and caregiver morale.
Lean Six Sigma Projects in Healthcare
n Increase admissions
n Enhance workflow efficiency
n Reduce poor use of materials
n Minimize deficiencies
n Improve planning and scheduling of human resources
n Make better use of facilities and equipment
About WillowTree Advisors, LLC
We are a woman-owned, small business specializing organizational transformations. Headquartered in Denver with services offered across the country, our team comprises over 40 professional advisors and technology experts with significant experience in change management, Lean and Six Sigma improvement, leadership development, and team building. We have worked with state, local, and federal agencies, and private firms, and in industries such as health care, high tech, manufacturing, aviation and transportation. We incorporate best practices from the health care sector and beyond, for a solid, cross-industry solution.
Our team members hold numerous certifications—Six Sigma, Lean, PMP ITIL, Certified Purchasing Manager, and others—and work with business and quality methodologies including MBO and TQM management strategies. Many of us are university instructors in quality management, Six Sigma, Lean business transformation, and purchasing/supply chain management. We also volunteer for Rocky Mountain Performance Excellence (RMPEx) and as National Baldrige Award examiners.
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