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NC Rural Hospitals Lean Together to Zap Waste

Alexandra Wilson Pecci, for HealthLeaders Media, August 31, 2011

Caldwell Memorial Hospital chose first to focus on its surgical value stream and trimmed everywhere, from cleaning out the physical waiting room space, to positioning tools exactly where they'd be needed, to creating "admit packs" so the patients' gown, bonnet, and booties were laid out and ready for them on the bed. As a result, they've reduced patients' surgical prep time by 60%.

Performing such a granular analysis of a value stream takes more than employee buy-in; it takes everyone being onboard and honest with themselves about their processes.

"It's remarkable to watch employees sit down and map out issues and discover possible solutions in a team environment and then have the wherewithal and the authority to implement these changes and see if they work," said Edgar Haywood III, president and CEO at Dosher Memorial Hospital, which is part of the new Eastern North Carolina Rural Hospital Lean Collaborative. The eastern collaborative was formed after the success of the western collaborative.

In addition to employee involvement, creating a truly lean institution requires a hands-on approach from the hospital CEO. Easton said the process will fail without complete CEO involvement.

"This is not something that you can delegate to one of your executives," she said. "I think lean is only really appropriate if the CEO is committed to changing the way they operate the organization, and learning too, and being part of running their organization in a new and different way."

Haywood says he agrees, and that lean is "a bottom up movement, but it's got to have top-down endorsement."

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