ERs taking lean management lessons from Toyota

Emergency rooms are taking lessons from companies including Toyota to cut costs, boost efficiency, and improve patient satisfaction, according to an article in the Wall Street Journal.

The article states that  long wait times that cause patients to leave before they are seen impacts hospitals bottom line, where revenue of about $450,000 is lost if even 1% of patients walk out of an emergency department with an annual volume of 50,000 patients.

Lean management principles that hospitals are adopting from outside the healthcare sector include:

  • ERs are posting wait times online and on public billboards.
  • Reserving beds for only very ill patients; less sick patients are offered a recliner or sent back to the waiting room to wait for test results.
  • Matching staffing levels to peak demand periods.
  • Using a staff "greeter" to circulate in the waiting room, check on patient and family concerns.

The article states that doctors are receptive to these efficiency programs, but warns they are just a "Band-Aid" on larger problems, such as the number of patients who are admitted to the hospital but left in beds in the ER because there are no inpatient rooms available.

(Sources: The Wall Street Journal,, August 2, 2012; The Advisory Board Daily Briefing,, August 3, 2011)