Waste and inefficiency in acute care settings reduces quality and patient satisfaction and increases cost. To address these problems, many health care systems use business improvement techniques developed by Toyota to redesign care processes.
ThedaCare, a five-hospital health system in Wisconsin, used workflow diagrams to identify problematic features of its inpatient care, including the existence of multiple care plans for the same patient, confusion in the mind of the patient about the plan of care, and poor communication among team members. To remedy these problems, the health system created teams composed of a physician, a nurse, and a pharmacist that visit the patient within 90 minutes of admission. After reviewing the patient's history, current health status, and health goals, the team devises a single plan of care.
In the acute care units in where the model was implemented, the cost of care decreased by 15 percent to 28 percent. The average length of stay fell by 10 percent to 15 percent and nurses' productivity rose by 11 percent. The percentage of patients rating their care as "excellent" rose to 95 percent in 2010 from 68 percent in 2006.