Table 3 An overview of the Lean intervention parts implemented at the three units
Lean intervention | Ward-I | Ward-II | ED |
|---|---|---|---|
Education/Training | 2 days training for the whole staff by external consultant | 2 days training for the whole staff by external consultant | Only Lean coaches were trained by the hospital’s Quality Development Group |
5S | Executed with keen employee involvement | Executed with the support of Lean coaches | Executed with the support of Lean coaches |
Value Stream Map | Executed by Lean coaches including employee discussions | Executed by Lean coaches | Executed by the flow group |
Continuous Improvement & Visual Management | Executed through employee discussions and sustained | Started by Lean coaches but couldn’t be sustained | Planned by the flow group but couldn’t be implemented |
Work Redesign | A joint working station for physicians and nurses, nurse aides equipped with trolleys having laptops, colored magnets for patient status, patients seen one by one. | One working station for physicians and nurses, nurse aides equipped with trolleys having laptops, colored magnets for patient status, patients seen one by one. | One working station for physicians and nurses, one part-time junior physician now full-time, ECG machine stationed in preliminary care room, heart coordinator to admit patients from ED to wards |
Teamwork | 2 care teams; in each team, physicians and nurses started working in pairs | 3 care teams; in each team, physicians and nurses started working in pairs | Team for preliminary care consisting of a nurse and a junior physician led by a specialist |