title: Rapid Process Optimization.
abstract: Health care systems have utilized various process redesign methodologies to improve care delivery. This article describes the creation of a novel process improvement methodology, Rapid Process Optimization (RPO). This system was used to redesign emergency care delivery within a large academic health care system, which resulted in a decrease: (1) door-to-physician time (Department A: 54 minutes pre vs 12 minutes 1 year post; Department B: 20 minutes pre vs 8 minutes 3 months post), (2) overall length of stay (Department A: 228 vs 184; Department B: 202 vs 192), (3) discharge length of stay (Department A: 216 vs 140; Department B: 179 vs 169), and (4) left without being seen rates (Department A: 5.5% vs 0.0%; Department B: 4.1% vs 0.5%) despite a 47% increased census at Department A (34 391 vs 50 691) and a 4% increase at Department B (8404 vs 8753). The novel RPO process improvement methodology can inform and guide successful care redesign.
authors.affiliation: 1 University of Colorado School of Medicine, Aurora, CO.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Wiler
authors.affiliation: 1 University of Colorado School of Medicine, Aurora, CO.
authors.forename: Kelly
authors.initials: K
authors.lastname: Bookman
authors.affiliation: 2 University of Colorado Hospital, Aurora, CO.
authors.forename: Derek B
authors.initials: DB
authors.lastname: Birznieks
authors.affiliation: 2 University of Colorado Hospital, Aurora, CO.
authors.forename: Robert
authors.initials: R
authors.lastname: Leeret
authors.affiliation: 2 University of Colorado Hospital, Aurora, CO.
authors.forename: April
authors.initials: A
authors.lastname: Koehler
authors.affiliation: 2 University of Colorado Hospital, Aurora, CO.
authors.forename: Shauna
authors.initials: S
authors.lastname: Planck
authors.affiliation: 1 University of Colorado School of Medicine, Aurora, CO.
authors.forename: Richard
authors.initials: R
authors.lastname: Zane
mesh_terms: D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007902:Length of Stay; D009936:Organizational Innovation; D016730:Program Development; D058996:Quality Improvement / Q000458:organization & administration*; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data; D013997:Time Factors
keywords: emergency care; lean; process improvement; process redesign; quality improvement