Reading Health System Goes Lean

David Schlappy explains how the health system reduced waste throughout multiple projects

After all the energy that went into completing the 7th Avenue Healthplex, a 476,000-square-foot surgical and inpatient tower, a break might have been in order for David Schlappy and Reading Health System. But rather than take a breather, the company has taken the momentum from that project and directed it into major improvements in the emergency department, cardiology, and interventional radiology.

“We’ve undertaken a more in-depth engagement of improving processes at this point,” Schlappy says. “We have an eye on the future.”

To make improvements, the hospital is using a lean improvement approach, inspired by Toyota in Japan, which looks to eliminate waste. There were glaring problems that everyone agreed needed to be addressed; for these, they used the A3 problem-solving approach, so-named because the structure fits on a 11×17 “A3” piece of paper. In addition to the A3 improvements, Reading staged multidisciplinary, “rapid-improvement” events, which engaged several staff members over a week to solve more complex problems.

One of those rapid-improvement events focused on the timeliness of lab results in the emergency department, a major factor in throughput. The team tested changes to how the results are ordered and saw a 20–30 percent reduction in turnaround times. The potential of the process, alogn with the tangible evidence, excited the team.

“The notion is that the leaders are helping to see and fix problems in a timely way, directly with their staff,” Schlappy explains. “This approach helps reduce fear about reporting problems and issues. Staff members feel empowered to drive improvement because they’re recognized for bringing problems forward. Problems become visible, and we work together to drive improvement.”

The hope is that the process and philosophy can take hold at all levels of the system, not just clinical. “Our intention is to expand these concepts in every operational and support process and area,” Schlappy says. “We can apply it to processes such as record abstraction, revenue cycle, HR onboarding, and pharmacy time to dispense medications. My goal would be to build improvement capability throughout the organization through hundreds of incremental improvements.”