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Miami Baptist Realizes $4.2 Million by Improving Patient Flow

Miami Baptist, a 520 bed facility located in Miami, Florida, was facing serious bed shortage and overcrowding in the Emergency Department. Inpatient volume was increasing at an alarming rate and the ED was frequently on diversion. Patients were "Leaving Without Treatment" (LWOTs) and overcrowding was affecting patient satisfaction scores as well as those of employees. Miami Baptist's senior management formed a multidisciplinary committee tasked with achieving rapid gains in patient throughput and patient flow.

Miami Baptist Deploys Lean-Six Sigma to Launch Noon Discharge

Miami Baptist's Needs

  • Improve bed control and discharge procedures
  • Increase patient throughput and reduce LOS
  • Reduce the number of diversions and LWOTs
  • Increase revenue and decrease operating costs

Miami Baptist engaged Caldwell  Butler & Associates (CBA) to support its initiative through the application of Lean-Six Sigma and its 100-Day Workout Productivity Series. CBA assisted senior management in identifying potential strategies to yield significant improvements in patient flow. The stated goal was not simply to empty beds, but to send patients home in a less stressful and more efficient manner. A secondary goal was to generate gains in financial performance through cost savings. During implementation, CBA employed its Accelerated DMAI2C method (Define-Measure-Analyze-Improve-Control) to validate the effectiveness of each proposed change and launch two waves of its 100 Day Workout.

Process Flow and Statistical Analysis: CBA deployed its expertise in Lean-Six Sigma methodologies to identify and quantify potential opportunities for improving bed control and reducing length of stay. The statistical analysis of the discharge process revealed that 60% of the patient discharges were occurring on the afternoon and evening shifts. Research also indicated the discharge process was leaving the patient and family increasingly dissatisfied. CBA used its extensive healthcare experience to identify opportunities for Miami Baptist to increase the percentage of patient discharged prior to 2:00pm. Analysis revealed this change would yield significant gains in capacity, patient satisfaction and financial performance.

Strategy Development: With the support of CBA, Miami Baptist organized into five teams. Each team focused on different areas including Pediatrics, Triage, Fast Track, Time to Diagnosis and Time to Discharge. The teams began assessing a multitude of possible strategies. Caldwell Butler & Associates provided the expertise to process flow analysis to assist each team in determining which Change Concepts would produce the most dramatic improvements.

Implementation of Rapid Cycle Testing: CBA provided its expertise to test and implement each of the identified Change Concepts. Methods of Rapid Cycle Testing were utilized to accelerate the achievement of results. The results of each project were analyzed using advanced statistical methods to quantify effectiveness and to estimate an ROI.

Demonstrated Results of Miami Baptist Implementation

As a direct result of the services provided by Caldwell Butler & Associates, Miami Baptist was able to achieve:

Demonstrated Results of Miami Baptist ImplementationMeasurable Benefits:

  • Noon discharges prior to 2:00 pm increased from 41% to 80%
  • ED manhour worked per patient visit decreased by 22%
  • ED Length of Stay (LOS) was reduced by 41%
  • Patient LWOTs decreased from 8% to less than 1%
  • Direct admissions increased by 181%
  • Patients held in ED due to bed availability decreased 37%
  • An ROI on Caldwell Butler & Associates of 10:1

Intangible Benefits:

  • Fewer patients sent to the ED by physicians due to bed shortage
  • Rapid deployment of proven methods and techniques for improving productivity
  • Sustainable processes through on-site mentoring and apprenticing