title: Using Lean principles to manage throughput on an inpatient rehabilitation unit.
abstract: Performance improvement is a mainstay of operations management and maintenance of certification. In this study at a University Hospital inpatient rehabilitation unit, Lean management techniques were used to manage throughput of patients into and out of the inpatient rehabilitation unit. At the start of this process, the average admission time to the rehabilitation unit was 5:00 p.m., with a median time of 3:30 p.m., and no patients received therapy on the day of admission. Within 8 mos, the mean admission time was 1:22 p.m., 50% of the patients were on the rehabilitation unit by 1:00 p.m., and more than 70% of all patients received therapy on the day of admission. Negative variance from this performance was evaluated, the identification of inefficient discharges holding up admissions as a problem was identified, and a Lean workshop was initiated. Once this problem was tackled, the prime objective of 70% of patients receiving therapy on the date of admission was consistently met. Lean management tools are effective in improving throughput on an inpatient rehabilitation unit.
authors.affiliation: Department of Physical Medicine & Rehabilitation, University of Michigan Health System, Ann Arbor, MI 48108, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Chiodo
authors.forename: Ruste
authors.initials: R
authors.lastname: Wilke
authors.forename: Rishi
authors.initials: R
authors.lastname: Bakshi
authors.forename: Anita
authors.initials: A
authors.lastname: Craig
authors.forename: Doug
authors.initials: D
authors.lastname: Duwe
authors.forename: Edward
authors.initials: E
authors.lastname: Hurvitz
mesh_terms: D017598:Efficiency, Organizational / Q000592:standards; D006757:Hospital Units / Q000458:organization & administration*; D006801:Humans; D017146:Models, Organizational; D016134:Organizational Policy; D010343:Patient Admission; D010360:Patient Transfer / Q000458:organization & administration; D012046:Rehabilitation / Q000458:organization & administration*; D012047:Rehabilitation Centers / Q000458:organization & administration*; D013647:Task Performance and Analysis