When Danville Regional Medical Center asked employees for ideas on how to improve, they came up with roughly 2,200.
“Change is coming about at Danville Regional Medical Center and every day, we’re focused on putting the patient first in everything we do,” said CEO Eric Deaton. “Step by step, we’re rebuilding an organization that improves quality of care and patient safety.”
Danville Regional and parent company LifePoint Hospitals Inc. recognized the need to retool how the hospital works to create a patient-centered culture and more efficiently use its resources — most importantly, its people.
Taking lessons from Toyota’s lean production, Danville Regional’s new lean philosophy doesn’t mean layoffs. It’s more about removing barriers to efficiency and encouraging innovation.
This could help meet the challenges of rising health-care costs and anticipated state cuts in Medicaid funding.
This past year, residents also asked for change when venting their frustrations with Danville Regional’s service as part of their support letters for Lynchburg-based Centra building an outpatient surgery facility with diagnostic imaging and emergency department in Danville.
Ultimately, the state health commissioner denied Centra’s application for a certificate of public need for the two operating rooms, saying it would be more cost-effective to rely on Danville Regional to increase the use of its own operating rooms. Yet, the commissioner also acknowledged the need for DRMC rebuild trust and breach divides within the community.
Dr. Robert Honea, general surgeon and chief of staff at Danville Regional, said he’s already started seeing concrete improvement that came with a new administration and leadership under Deaton. As a last resort, Honea had called Centra for help in providing patients who refused to go to DRMC another option.
Now that DRMC isn’t just talking, but is actually doing, seeking outside help isn’t necessary, except for continued collaboration with larger hospital systems, he added.
“It is like night and day,” Honea said. “There’s no doubt things have improved.”
Honea is also excited about the new lean management strategy and employee engagement. His office, a small business, has always needed the employees’ ideas on how to save money.
The new administration listens to doctors’ needs, which improved relationships there.
“To me, the deal is having the public,” Honea said. “We just have to keep doing good so word gets around that things are getting better.”
In lean management, employees are empowered to “stop the line,” ask questions and bring up issues to ensure the best possible care for the patient, said DRMC Chief Medical Officer Dr. Saria Saccocio.
The ideas
“The ideas for change and improving patient care come from the front-line employees and the people who are closest to the care of the patients,” Deaton added.
Of the 2,200 ideas, more than 100 were classified as “just do its.” Those ideas can be implemented within 10 days and less for $1,000.
Other ideas are process-oriented or involve multiple departments. That’s when employees step back and examine the process, eliminating unnecessary steps for streamlining.
For instance, it used to take 35 steps to admit a patient to the hospital, Deaton said. Now, after a new process was implemented on Dec. 16, it takes 15, reducing the admission wait from hours to the goal of 90 minutes.
Additionally, eliminating steps also freed up nurses to go to the Emergency Department where they’re more needed, Saccocio said.
Next, Danville Regional will look at the discharge process and improving the time it takes patients to see a physician upon coming in the door.
All of these processes are part of the Emergency Department process, Deaton said. For instance, patients can’t be admitted until beds are available after other patients leave.
While this helps efficiency, it also means getting patients cared for and back home, Saccocio said.
DRMC aims to improve at least one process a month and generate 100 new ideas monthly, Deaton said. Goals include improving customer service, quality measures, finances and ultimately, the care of the patient.
The lean philosophy is continual improvement, meaning the examination and change would continue indefinitely.
“I’m really encouraged by the positive change that’s happened and encouraged by the changing culture that we’ve seen, but I’m not satisfied, Deaton said. “What concerns me, we need to make sure we’re constantly improving, not becoming complacent.”
