Virginia Mason Hospital

Time WASTED  Looking for patient information, duplicate charting, checking on orders, trying to get old records, calling lab to see if a specimen was received, consulting with other nurses to figure out a handwritten order, calling physicians, searching for a drug book, figuring out a care plan, checking on orders (again). Time SAVED  EMRs

The nurses at Memorial Hospital work a regular schedule of four 10-hour days per week. The average regulartime pay across all nursing grades is $12.00 per hour. Overtime may be scheduled when necessary. However, because of the intensity of the demands placed on nurses, only a limited amount of overtime is permitted per week. Nurses may be scheduled for as many as 12 hours per day for a maximum of five days per week. Overtime is compensated at a rate of $18.00 per hour. In periods of extremely high demand, temporary part-time nurses may be hired for a limited period of time. Temporary nurses are paid $15.00 per hour. Memorial Hospital has a policy that limits the proportion of temporary nurses to 15 percent of the

“Lean is a systematic approach to identifying and eliminating waste (non-value-added activities) through continuous improvement by flowing the **product at the pull of the customer in pursuit of perfection.” Lockwood [24].

Every day veterans are unattended to, or their appointments are rescheduled. So many veterans are homeless because they can’t or won’t be hired, to me this is unfair. I know many veterans that would rather not go to the VA or be cared for at the VA because of their lack of being cared. The way I see it is, if the people/ workers at the VA work there they should know what they’re getting themselves into. yes the VA is insane, and deranged etc., but hey if you work there stay committed to help and take good care of our veterans, to help the people who is or have fought for our country as a favor in return to

“The mission statement is a short, concise statement describing the purpose and reason for existence. It serves as the framework for the vision statement, which is composed of the key characteristics that leadership desires the organization to become” (Spallina, 2004). Baptist Memorial Hospital-Memphis is one of Tennessee’s highest volume hospitals. Baptist Memorial Healthcare mission is to follow the three-fold ministry of Christ- healing, preaching and teaching. The organization has many programs in place to spread the practices of Christ to the many communities that the hospital serves. The vision is that the organization “will be the provider of choice by transforming the delivery of health care through partnering with patients, families,

Vanderbilt University Medical Center (VUMC), a non-profit medical center, was founded in 1874 as a part of Vanderbilt University (Wood, P. 1). The U.S. News and World Report ranked VUMC as one of the top health organizations in the United States for patient care, research, and medical education (Vanderbilt Fact Book 2015). In addition, VUMC is a charity hospital that provides about $400 million in charity care per year (Framework, 2013). It should also be noted that Vanderbilt is the only level one trauma center and level four Neonatal Intensive Care Unit in this region. Vanderbilt is also unique for its comprehensive cancer center, dedicated burn center, and has Tennessee’s only solid organ transplant center, per the Vanderbilt Fact Book

Pocahontas Memorial Hospital (PMH) is the only hospital in rural Pocahontas County, West Virginia. It is a 25 bed critical access hospital with a rural health clinic (RHC) located within the hospital. Like other rural healthcare systems, PMH faces face a myriad of challenges due to geographic isolation, lack of economies of scale, lower socioeconomic status, higher disease burden, and substantial access barriers (U.S. Department of Health and Human Services [HHS], 2010). As a result, PMH struggles with meeting the healthcare needs of the community.

Tracking patient history, medications, procedures and other information is much easier and communicating this information with other providers is much more effective.

Resulting in less time for the patients needs and concerns to be addressed. Removing the focus away from client orientated care to budget orientated care.

Greater efficiency and cost savings – Digital records and integrated communications methods can significantly cut administrative costs, including reducing the need for transcriptions, physical chart storage, coding and claims management, as well as facilitating care coordination and reducing the time it takes for hard-copy communications among clinicians, labs, pharmacies and health plans.

Information technology helps the organizations achieve many targets. The following is a needs assessment conducted in the Valley Hospital Medical Center, to determine the technology needs. This hospital does not lack an advanced technology, still, it has room for further improvement. For instance, they use the latest version of a computer program for the patient documentation. They make sure that the program gets updated as needed. There are no issues for any employee or department of this institution on accessing or documenting using this program.

The Delphi panel stressed the importance of regular performance measuring to ensure improvements are sustained. When staff understood the reasons behind the changes and how they improved the productivity and quality of care for patients, they were more likely to sustain the implementations. Developing a culture with the appropriate elements to support continuous improvement was seen as vital to see success with the lean methodologies.

The application and implementation of lean principles or thinking is a process that requires commitment from every stakeholder in the organization. This process entails commitment to the organization's workers and to the system itself in order to make changes towards improvement. Generally, the implementation of lean thinking is geared towards continuous improvement through the elimination of waste. However, lean management or implementation of the principles sometimes incorporate mistakes that are made by leaders in the execution process. This is mainly because lean leadership appears to be simple though its complex because of the costs associated with it. The mistakes usually occur because of intrinsic complexities of exploring deeply into organizational philosophies, business strategy, psychology, and macroeconomics.

Lean is defines the manufacturing philosophy that reduces the time between the shipping and customer demand, which based on the systematic method by eliminating waste, that means giving the customer what they want when they want it, and don 't waste whatever. Rahmana, Sharif and Esa (2013) suggested lean production is mentioned to improve the company 's performance from the philosophy in reducing waste in order. That means, lean system destination is the decrease cost by removing the non-value activities, which they are applying a category of tools and techniques for checking and eliminating defective in the production process. In the Evenort Company should emulate the five overriding principles of lean thinking in terms of implementing lean that there is guarantee the company has been driving correctly in the lean manufacturing (Cardiff 2015) as can show in table 1.

Lean is a process where creating more value to customers by minimizing wastage, time with less resources. Lean organization understand the customer value and try to increase proceed which adding more value to the business. In order to accomplish the lean thinking