Hospital Patient Tower Project:
Issue Faced: Decentralize patient care, moving process and consumables closest to the patient.
Challenges:
A. Change the traditional nurses station to a welcome desk.
B. Move charting to the patient beside.
C. Match technology with process to reduce work stress and improve outcomes.
D. Provide for scalability to adjust staffing to patient occupancy.
E. High turnover in Facilities leadership and support services staff resulting in less than optimal operational costs.
Principals of Lean used for analysis:
A. Value Improved outcomes for Patient. We strongly believed in the need to transition from a hospital institutional environment to that of a hospitality environment with highly specialized services.
B. Value Stream We looked at the following issues to improve the patient care process:
1. Steps traveled by Nurse in the work environment. This lead to a decentralized nurse station process, placing workstations between every two rooms and the charting process at the patient bedside.
2. Distributed consumables to the remote workstations for easier access and reduced travel distance.
3. Change the housekeeping process from a department responsibility to a zone concept to emulate the hotel process of cleaning space.
4. Change food distribution from a nursing responsibility to a food service responsibility.
C. Flow Implementing the value stream solutions required:
1. Involving team leaders in patient care, housekeeping, maintenance, and central stores to be involved in the design process of the new space.
2. Evaluation of technology as to how care could be brought to the patient; how consumables could be located to the closest point of use; how housekeeping and maintenance could transition to a hotel / concierge service.
3. Education needed to explain the designed space and how each process interacts with the Built Environment, Staff, and the Patient.
4. Scalability of process so staffing could adjust to shifts in patient population.
D. Patient Outcomes this stage involved:
1. Surveying recent patients who experienced existing patient floors for input on what they would like to see improved.
2. Understanding the concept of a healing environment and how it impacted the patient experience.
3. Developing new standards for patient care processes and implementing a training program for staff.
4. Monitoring patient satisfaction scores for the new Patient Tower.
E. Brand Loyalty What can we do to make this facility:
1. The place everyone wants to come for care?
2. The preferred place for employment?
3. One of Excellence by consistently striving to improve the process of reducing effort, time, space, cost, and errors while offering the patient care services the community served needs.

Results:
A. Reduced facility cost per discharge from $38.87 to $26.80.
B. Reduced facility cost per patient day from $294.80 to $116.23
C. Reduced projected cost of project from $175 million to $146 million
D. Increased square footage of project from 200,000 SF to 550,000 SF.
E. Facility Operating cost savings year 2 of operation exceeded $1 million.
F. Patient satisfaction (Press Ganey scores) increased.