NDLI: Dissecting delays in trauma care using corporate lean six sigma methodology.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Parks, Jennifer K. Klein, Jorie Frankel, Heidi L. Friese, Randall S. Shafi, Shahid
Description	Country affiliation: United States Author Affiliation: Parks JK ( Department of Surgery, Division of Burns, Trauma and Critical Care, University of Texas Southwestern Medical School, Dallas, Texas, USA.)
Abstract	OBJECTIVE: The Institute of Medicine has identified trauma center overcrowding as a crisis. We applied corporate Lean Six Sigma methodology to reduce overcrowding by quantifying patient dwell times in trauma resuscitation units (TRU) and to identify opportunities for reducing them. METHODS: TRU dwell time of all patients treated at a Level I trauma center were measured prospectively during a 3-month period (n = 1,184). Delays were defined as TRU dwell time >6 hours. Using personnel trained in corporate Lean Six Sigma methodology, we created a detailed process map of patient flow through our TRU and measured time spent at each step prospectively during a 24/7 week-long time study (n = 43). Patients with TRU dwell time below the median (3 hours) were compared with those with longer dwell times to identify opportunities for improvement. RESULTS: TRU delays occurred in 183 of 1,184 trauma patients (15%), and peaked on days with >15 patients or with presence of five simultaneous patients. However, 135 delays (74%) occurred on days when
File Format	HTM / HTML
ISSN	00225282
Issue Number	5
Volume Number	65
e-ISSN	15298809
Journal	The Journal of Trauma: Injury, Infection, and Critical Care
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2008-11-01
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Therapy Emergency Service, Hospital Outcome And Process Assessment (health Care) Wounds And Injuries Humans Trauma Centers Length Of Stay Urban Population Discipline Traumatology Journal Article Patient Care Total Quality Management Time Factors Statistics & Numerical Data Process Assessment (health Care) Efficiency, Organizational
Content Type	Text
Resource Type	Article
Subject	Surgery Critical Care and Intensive Care Medicine

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