In the last decade, healthcare has undergone a complete transformation by using the principles and tools of Lean Six Sigma. Teams of nurses, doctors, and care providers are gathering data, mapping their processes, and performing root cause analysis to solve complex problems and improve patient care.

The case study below shows how we helped a hospital use the Lean Six Sigma DMAIC process to reduce the length of stay for patients in their Emergency Department. This dramatically improved patient satisfaction and reduced stress on the ED staff.


Case Study: Using Lean Six Sigma in Healthcare to Reduce Patient Length of Stay in the Emergency Department

Step 1: Define the Problem

The nurses say we need to build a new, bigger, Emergency Department.

Phil Eaton, CEO, Mountain West Medical Center

When Phil, the CEO of a regional hospital, told me they were considering adding a new wing with 10 or more beds to his Emergency Department… he looked concerned. It was going to be expensive. And while the surrounding communities were growing rapidly he wasn’t sure it was necessary.

The feedback from the ED docs and nurses was clear. There are too many days when we are overcrowded and don’t have room for patients.

Step 2: Measure the Process and Gather Data

After meeting with the ED Director, Scott, we agreed to gather some data. We tracked the LOS (Length of Stay) for each patient through the ED. I explained Little’s Law and the fact that long cycle times would increase the number of patients in the ED and could be the root cause of the problem.

I-MR Chart of ED LOS Length of Stay Before Data - Summary Report - Lean Six Sigma Toolbox

Now we had data! But what is the goal and how were we performing against it?


A 5 star hospital should process patients through the Emergency Department in 120 minutes (2 hours) or less.


To understand how well the ED was performing we needed a process capability chart.

ED LOS Before Process Capability - Lean Six Sigma Toolbox

Wow. 46% of our patients were staying longer than 150 minutes or 1 and 1/2 hours. What could be the cause? We needed to find the reason patients were staying over 120 minutes so we implemented a tick sheet.

Step 3: Analyze the Data and Find the Root Cause

ED reason codes for length of stay over 120 minutes. Lean Six Sigma Toolbox

This data was eye-opening. We didn’t identify one silver bullet but rather several processes that needed to be improved to reduce our Length of Stay. Most of the delays were caused by hand-offs between the ED and the lab or ED and radiology.

Step 4: Improve the Process… Kaizen!

Armed with this data we kicked off a series of Kaizen Events (rapid process improvement projects). Working with teams from the lab, imaging, and the docs, we found several creative ways to improve communication and reduce delays.

  • Improve patient pickup time from ED to RAD
  • Reduce delays in draw pick up and drop off from the LAB
  • Improve visibility of DOOR to DOC and total LOS in progress
  • Simplify the patient admission process

Step 5: Control the Process and Show Results

  • Patients love their new, faster, local Emergency Department at Mountain West Medical Center! There’s never a wait and they know they will get the best care without the wait.
  • We reduced the average Length of Stay from 185 to 150 minutes within a month then continued to work on projects until the average LOS was well under 110 minutes.
  • The hospital has been operating with the same number of beds for over 3 years now and never has overflowed.
  • No need for a multi-million dollar expansion.
  • ED nurses and docs are happier.
  • The communication and relationship between ED – Radiology and ED – Lab improved.
Emergency Department before and after length of stay. Lean Six Sigma Toolbox

Will Lean Six Sigma work for us?

Yes! We have implemented Lean Six Sigma in healthcare organizations like hospitals and clinics just like yours. Because of our global clientele, it is likely we’ve worked on problems similar to what you are seeing, before. We are not “trainers” but practitioners who focus on getting measurable results within just a few weeks.

    Here are the 2 best ways to get started.

    1. Onsite Lean Six Sigma Green Belt Training + Boost
      • This program kicks off multiple projects in your company, each yielding a significant payback
      • We come to your facility, training leaders and team members in Lean Six Sigma tools and principles
      • Teams select and complete meaningful projects that are aligned with your goals
      • Project teams are coached every step of the process so their first experience using Lean Six Sigma is a good one
      • Teams report out on their projects giving total savings ($10k to $100k+ per project is typical), as well as improvements to quality, employee, and customer satisfaction
    2. Kaizen System Implementation
      1. This program helps individual departments set up a system for Continuous Improvement making Kaizen a part of their culture
      2. We come onsite and help leaders identify KPIs (Key Performance Indicators) and set goals
      3. Together teams establish routines including daily huddles and data analysis while creating standard work for critical processes
      4. Finally, teams kick off a series of small projects using the Kaizen System to address waste and variation discovered through their daily Kaizen routine

    Implementing Lean Six Sigma in Healthcare

    If you are interested in creating a culture of Continuous Improvement in your hospital or clinic, call us! Let’s discuss your needs and how we can help you reach your goals this year.