Wishing Farewell to Assembly Line Treatments
More time for patients, less walking – The Hospital Center in Biel, the second largest hospital in the Swiss canton of Bern, relies on Lean.
Changing how care is organized can have great eff ects: For some time now the nursing staff at the Biel Hospital Center in Switzerland has been organized into teams of two, each responsible for about eight patients. The result: Less stress and more time for patients. “There are still traditional wards with more than 30 beds, but work is no longer completed like on an assembly line,” says Christian Baum, Head of the Project “Lean Hospital” at the Hospital Center.
Care in the past: Rushing around the ward without a plan
How care is traditionally organized is inefficient and often impersonal for patients: door opens, nurse brings in medicine, door closes, a break, door opens, another nurse measures blood pressure, door closes. A group of nurses and doctors make their way from room to room on their rounds. Nurses are constantly running after their tasks and their workflow is continually interrupted. This results in a mad rush. The nursing staff as well as doctors are stressed, and rounds dwindle into examinations like on an assembly line and go on and on as other appointments are waiting.
However, because operations were restructured according to Lean principles, things are now different in the wards at the Hospital Center. Each ward is divided into four zones, i.e. several rooms with about eight patients. One nurse and one nursing assistant each organize the care. They no longer rush from patient to patient, but rather plan tasks according to the need for care and the needs of their patients. They are viewed more as “customers” and not just as sick people in need of care.
Clearly classifying patients into zones makes team meetings much more efficient. Organization of doctors‘ tasks and rounds is signifi cantly improved and patient safety is also increased.
“Nurses and physicians now have the opportunity to calmly perform their tasks and devote more time to individual patients,” says Christian Baum. As a result, care has become much more personal from patients‘ point of view. A nurse or caregiver will bring medicine, monitor blood pressure and other vitals. They organize everything related to the patient such as ordering food and much more.
Care today: Reorganized according to Lean principles
If you are familiar with Lean, you will immediately notice that the principle of group work from modern Lean production has been the inspiration for how zones are structured. Like in production, small teams are responsible for a specific area that they essentially organize themselves. Another Lean principle is preventing unnecessary movement. This was particularly helpful in the dialysis ward, where patients receive outpatient treatment several times a week.
Dialysis involves quite a lot of material, from gauze, band-aids and needles to freshly sterilized tubing and adapters for dialysis machines. “In the past, it was common for individual caregivers to run around right before a patient arrived, pick up what they needed from the storage room down the hall and place them on separate carts,” says Christian Baum. “Now, all necessary materials are delivered for each individual. Nurses can focus on each patient.” The “Lean Hospital“ project clearly shows that more efficient process organization with a focus on quality and process reliability is also helpful in health care, as has been standard in industry for a long time. “Standardized treatment paths with synchronized processes and predictive planning starting from initial contact with the patient to follow-up care make it easier to organize activities in the hospital and plan assignment of personnel,” emphasizes Christian Baum. “Thanks to its implementation, Lean reduces stress overall and patients receive exactly what they need to recover: rest, attention and the necessary information on the treatment process.”