Lean Methodology used to redesign processes
Patients waiting for surgery no longer have to make multiple visits for tests and consultations. Instead, the Jewish General Hospital’s (JGH) Pre-Surgical Screening Clinic provides a one-stop service in a centralized clinic designed to minimize waiting time. This is the latest JGH project to achieve the goals of Transformational Change, a hospital-wide program to heighten efficiency in patient care and provide a better working environment for staff using the management principles of Lean Methodology and Operations Research.
In the past, patients often visited the hospital more than once to meet with healthcare professionals who assess their physical condition and suitability for surgery. A set of specific procedures has been developed for the nurses to use as a triage tool, determining which types of tests the patient requires in connection to the outcome of that patient’s surgery.
“This setup allows one physician to address all of the relevant medical questions in a single visit, while standardizing the way patients are prepared for surgery,” says Dr. Beth-Ann Cummings, a physician in the Division of Internal Medicine. “The process is more efficient and effective, and it reduces the number of visits that patients must make leading up to surgery.”
The design of the new clinic and its processes is the outcome of work performed by a multidisciplinary team representing such departments as Surgery, Anesthesia, Internal Medicine, Pharmacy, Nursing and Medical Records. Work flow was analyzed by Dana Porubska, the Coordinator of Pre-Surgical Services, and Dr. Nadia Lahrichi, an Operations Research Expert andmember of the Transformational Change Steering Committee. A simulation model was then developed by Dr. Phil Troy, an Associate in the Department of Surgical Services and also a member of the Transformational Change Steering Committee.
“We used simulation based optimization to simultaneously determine needed space and staff capacity, as well as to minimize physician idle, overtime, and excessive patient waiting,” says Dr. Troy. “As far as we know, this type of simultaneous optimization of a clinic has not previously been done anywhere else.”
"By streamlining the Pre-Surgical Screening process, the JGH has demonstrated its determination to provide superior medical treatment and to make all aspects of the patient's hospital experience as smooth and stress-free as possible," says Dr. Hartley Stern, Executive Director. "In using the Transformational Change program to upgrade the clinic, we have improved the hospital's efficiency and the quality of its care. Ultimately, this means a reduction in costs, contributing to additional benefits to patients further down the road."
Glenn J. Nashen, Director
Astrid Morin, Media Relations
Public Affairs and Communications
Jewish General Hospital
Tel.: 514-340-8222 ext. 4612