Lean manufacturing principles applied to stroke treatment

Lean manufacturing principles applied to stroke treatment

Lean manufacturing principles applied to stroke treatmentA manufacturing process developed by Toyota to increase efficiency in Japanese car factories is helping an unexpected group of people: those suffering from strokes. Science Daily recently spotlighted a paper in the journal Stroke, which describes how the process was able to improve stroke treatment at Barnes-Jewish Hospital where approximately 1,300 stroke patients are treated annually.

Many have heard the slogan “Time lost is brain lost” in regards to stroke. The quicker that treatment can begin the more chance there is to prevent brain damage that can cause paralysis and loss of speech following a stroke. Researchers from Barnes-Jewish Hospital said that their drop in treatment time resulted from applying a a principle of lean manufacturing to the care of their patients. This key component was to get input from all members of the team to identify inefficient steps.

Jin-Moo Lee, MD, PhD, is an associate professor of neurology at Washington University School of Medicine in St. Louis and also director of cerebrovascular disease in the Department of Neurology. He was a senior author on the paper and told Science Daily, “We sought suggestions from everyone involved, from the paramedics who bring in patients, to admitting clerks, radiology technologists, nurses and physicians. Once the inefficient steps were identified, we developed a completely new protocol that eliminated them. This new treatment protocol helped us achieve one of the fastest door-to-needle times in the country.”

One step that was identified as wasteful was moving patients. The staff found that it would increase efficiency for paramedics to bring patients suspected of stroke directly to the emergency department’s CT scanner for evaluation rather than to a patient exam room.

The main loss of time was getting tests back from the lab. The doctors found that these same tests could be performed at bedside in minutes instead of sending blood to a lab and waiting 30 minutes for results. Following stroke the first 60 minutes are crucial to receive proper treatment. It’s during this window of time that a clot-busting drug called tPA can safely be administered. The drug can cause dangerous bleeding in the brain and so cannot be administered after too much time elapses.

The new treatment procedures have been in affect for less than a year, but have lowered average door-to-needle times by nearly 40 percent and have also increased the percent of patients treated within the first hour from 52 to 78 percent.

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