SHM Converge Scientific Abstract ePoster Gallery-Geography Reinvented: How Utilizing Lean Thinking Can Transform a Vision Into Reality With Many Successful Measurable Outcomes

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<strong>Summary (300 words or less):</strong>

During the COVID-19 pandemic, hospital systems were overwhelmed by increased patient volume, staffing strain, and supply shortages. To reduce infection spread, limit time spent outside patient rooms, and improve workflow efficiency, the hospital began implementing geographic team-based care. As case numbers improved, the team expanded this idea into a hospital-wide geographic system intended to prepare for future surges and evaluate its effect on operational metrics.

The project was led by Hospital Medicine using Lean methods and brought together physicians and advanced practice providers from Internal Medicine, the Emergency Department, Cardiology, and Geriatrics, along with bed board staff, nursing, and hospital leadership. Over eight working sessions, participants reviewed progress, identified barriers, and assigned tasks. Approved changes were incorporated into a new standard work manual, and a smaller follow-up team ensured the workflows were followed and refined.

Key interventions included creating teaching and non-teaching medicine geographic teams, an ED-based medicine team called the STAR Team, redefining STAR Team roles, and developing new workflows for telemetry, cardiology, and geriatric provider assignment.

The initiative produced measurable improvements. ED tele downgrades increased by 50%, while the proportion of patients initially assigned to telemetry decreased by 18% without a change in volume. Geographic units saw a 65% increase in discharges before noon. ED admission-to-inpatient discharge rates improved by 30%.

Overall, the project showed that Lean-driven, multidisciplinary geographic redesign can improve hospital flow, reduce unnecessary telemetry use, and support more efficient discharges. Future work will reassess these metrics after the COVID surge and further evaluate the effectiveness of the STAR Team.

Asset Subtitle

Sarah Shihadeh

Meta Tag

Author List Sarah Shihadeh, Mary Akella, Brian Radbill, Lucy Xenophon

Category Innovations

Concept Geographic Team-Based Workflow

Concept Patient Flow

Concept Lean Methodology

Concept COVID-19 Spread

Concept Workflow Design

Distinguished Non-Finalist

Presenter Organization Overlook Medical Center

Presenting Author Sarah Shihadeh

Track Quality Improvement

Keywords

COVID-19 pandemic

hospital flow

geographic team-based care

Lean methods

multidisciplinary collaboration

telemetry reduction

discharge efficiency

STAR Team

hospital operations

workflow redesign

Geographic Team-Based Workflow

Patient Flow

Lean Methodology

COVID-19 Spread

Workflow Design