Nasim Afsar-Manesh1, Sarah Lonowski2, Aram A Namavar3. 1. University of California, Department of Medicine, Los Angeles, USA. Electronic address: nafsarmanesh@mednet.ucla.edu. 2. David Geffen School of Medicine at UCLA, USA. 3. University of California, Department of Medicine, Los Angeles, USA.
Abstract
INTRODUCTION: UCLA Health embarked to transform care by integrating lean methodology in a key clinical project, Readmission Reduction Initiative (RRI). METHODS: The first step focused on assembling a leadership team to articulate system-wide priorities for quality improvement. The lean principle of creating a culture of change and accountability was established by: 1) engaging stakeholders, 2) managing the process with performance accountability, and, 3) delivering patient-centered care. The RRI utilized three major lean principles: 1) A3, 2) root cause analyses, 3) value stream mapping. RESULTS: Baseline readmission rate at UCLA from 9/2010-12/2011 illustrated a mean of 12.1%. After the start of the RRI program, for the period of 1/2012-6/2013, the readmission rate decreased to 11.3% (p<0.05). CONCLUSION: To impact readmissions, solutions must evolve from smaller service- and location-based interventions into strategies with broader approach. As elucidated, a systematic clinical approach grounded in lean methodologies is a viable solution to this complex problem.
INTRODUCTION: UCLA Health embarked to transform care by integrating lean methodology in a key clinical project, Readmission Reduction Initiative (RRI). METHODS: The first step focused on assembling a leadership team to articulate system-wide priorities for quality improvement. The lean principle of creating a culture of change and accountability was established by: 1) engaging stakeholders, 2) managing the process with performance accountability, and, 3) delivering patient-centered care. The RRI utilized three major lean principles: 1) A3, 2) root cause analyses, 3) value stream mapping. RESULTS: Baseline readmission rate at UCLA from 9/2010-12/2011 illustrated a mean of 12.1%. After the start of the RRI program, for the period of 1/2012-6/2013, the readmission rate decreased to 11.3% (p<0.05). CONCLUSION: To impact readmissions, solutions must evolve from smaller service- and location-based interventions into strategies with broader approach. As elucidated, a systematic clinical approach grounded in lean methodologies is a viable solution to this complex problem.
Authors: Alexander Komashie; James Ward; Tom Bashford; Terry Dickerson; Gulsum Kubra Kaya; Yuanyuan Liu; Isla Kuhn; Aslι Günay; Katharina Kohler; Nicholas Boddy; Eugenia O'Kelly; Joseph Masters; John Dean; Catherine Meads; P John Clarkson Journal: BMJ Open Date: 2021-01-19 Impact factor: 2.692
Authors: Juan A Marin-Garcia; Pilar I Vidal-Carreras; Julio J Garcia-Sabater Journal: Int J Environ Res Public Health Date: 2021-01-22 Impact factor: 3.390