Our greatest challenge in sustaining the early gains
produced by adopting Lean has been to keep up with the
growth in patient visits. Interestingly, for 3 weeks after
the Kaizen event we never put a patient in the waiting
room. Maintaining the specific process improvements
that have been implemented since adopting Lean has
been relatively easy because they were generated by
frontline staff that was performing the process. Although
we found the week-long Kaizen event useful as a kickoff
to Lean, it has since been replaced with much shorter
2-day events focused on specific process areas, for example,
radiology testing of ED patients. During these
events and throughout the year, management encouraged
staff to make recommendations on how to improve flow
and quality and worked to institute the suggestions that
have the greatest impact on value.