Rural hospitals learn 'Lean Healthcare' to the benefit of both patients and providers

TERRE HAUTE, Ind., and WEST LAFAYETTE, Ind. - Throughout the past year, 20 of Indiana's 35 Critical Access Hospitals began implementing Lean Healthcare methodologies to improve the quality, safety and efficiency of patient care while also improving economic vitality.

Critical Access Hospitals (CAHs), which are characterized as small, generally geographically remote facilities that provide outpatient/inpatient hospital services to rural areas, participated in training made possible through funding from the National Rural Health Resource Center's Flex Programs aimed at enhancing quality and performance improvement. The Indiana Rural Health Association (IRHA), which manages the Indiana Flex Program, contracted with Purdue University to provide CAHs with an introduction to Lean Healthcare.

Purdue Healthcare Advisors provided training and coaching focused on assisting each hospital to improve one of three key quality issues: 1) patient transitions of care; 2) emergency department patient flow; and 3) unnecessary patient readmissions. With guidance from Purdue, each hospital assigned an internal, multidisciplinary team to learn and to apply the concepts, principles and methodologies of Lean Healthcare to their selected issue. Improvement following the implementation of evidence-based practices and technology optimization included patient wait times reduced by 25 percent; patient wait times for admission from the emergency department reduced by 22 percent to 77 percent; and avoidable patient hospital readmissions reduced by 44 percent.

"IRHA has identified a significant need for the evaluation of acute care processes with Critical Access Hospitals," said Don Kelso, IRHA executive director. "The kinds of results that some of these CAH teams were able to produce - reducing the average times for patient transfers from emergency department to inpatient by more than 70 percent as well as reducing avoidable inpatient readmissions by more than 40 percent - tell us that Lean Healthcare methodologies can be applied successfully throughout the health-care industry.”

More than 150 workers from the front line to the executive suite received Purdue Healthcare Advisors training. Approximately 100 achieved certification from Purdue as a Lean Healthcare "Yellow Belt," and 60 continued on to receive advanced training with plans to pursue certification as a Lean Healthcare "Green Belt" and "Black Belt."

Mary Anne Sloan, director of Purdue Healthcare Advisors, said the initiative helped the CAHs adopt a culture of continuous improvement.

"True and sustainable improvement comes when a hospital culture incorporates the lean philosophy and its methodologies from the top down, the bottom up and across the board," Sloan said. "Transforming health care requires an approach that helps CAHs and other hospital systems heal themselves, even as they face increased regulatory demands that will affect how they must care for their patients.”

About the Indiana Rural Health Association

The Indiana Rural Health Association is a not-for-profit corporation developed for the purpose of improving the health of all Indiana citizens in rural settings. IRHA is a member-driven organization composed of a diverse membership.

About Purdue Healthcare Advisors

Purdue Healthcare Advisors is a not-for-profit, healthcare consulting resource that combines clinical and technological expertise with the global resources and the expertise of Purdue University to improve care, manage margins and facilitate compliance.

Participating hospitals in the Indiana Flex Program-CAH Lean Project for 2012:

Northern Indiana

Central Indiana

Southern Indiana

Note to Journalists: A listing of the participating hospitals along with contact information is attached.