Seattle Children

by HCE Exchange on August 19, 2010

102-year-old Seattle Children’s Hospital serves a geographic region that covers more than 20% of the total land mass of the United States. Children and families in Washington, Idaho, Montana and Alaska rely on the organization’s promise to provide the highest quality of healthcare, regardless of a family’s ability to pay. For a few specialized procedures, children from across the nation come to the hospital for treatment.

Seattle Children’s is a 250-bed hospital with approximately 4,400 staff. On a daily basis, the hospital averages 85% capacity and occasionally runs at 100%. This means that on any given day there are units within the hospital that have every bed full. Surgeries are sometimes cancelled because there is not an empty bed for a child once the surgery is over. The hospital recently announced that it had to divert 79 children to other hospitals last year for lack of space.

Growing Concern for the Future

“Our number one concern is having enough beds for the future,” says Dr. Thomas Hansen, CEO.

Seattle’s Hearing Examiner recommended the City Council deny Seattle Children’s proposed expansion plan in August of this year. Developing the plan has taken more than two years and involved 30 community meetings. The hospital had already received recommendations for approval from the Citizen’s Advisory Committee and the Seattle Department of Planning and Development.

There are several factors fueling patient population growth. The region is growing and the demographics are shifting. “The majority of the patients in our hospital now have life-long, chronic illness,” says Hansen. “Something they are going to have to deal with every day of their lives. The majority of our patients are going to keep coming back.”

Advances in medicine are one contributing factor to a full hospital. “We have gotten very, very good at prolonging lives of children with serious chronic illnesses, and this is great news,” says Hansen. But the end result is that more beds are needed because those children with chronic illnesses are going to spend more time, potentially over longer periods of time, in the hospital for continued treatment.

If the hospital is able to commence expansion in early 2010, as planned, it is expected to increase bed capacity by 130 to 180 beds in the next five years. They project a need of 250 to 350 additional beds in the next 20 years and are focusing on developing a plan that is scalable to match growth in the coming years. Seattle Children’s current growth rate of around 6% is nearly double that of the national average for children’s hospitals.

Growing Lean Principles for Continuous Performance Improvement

Seattle Children’s Hospital is also on a mission to reduce waste, defined in healthcare as any activity that doesn’t directly add value for the patient or the patient’s family. From a patient’s perspective, very little of what goes on in a hospital provides value. Hansen and his colleagues put the average time wasted at about 95%, and while some of that time not directly impacting the patient is necessary—registration, records, moving a patient—much of it can be reduced or eliminated.

The hospital has adapted the principals of Toyota’s Lean production system to meet a goal. The expectation is that the hospital should be able to be directly adding value for each patient at least 50% of the time. “Lean endeavors are ingrained in our culture,” says Hansen. “It is the first tool we reach for whenever we have a problem. We focus on improving the system and keeping the waste out of the system. Both are critical for having the highest quality healthcare.”

The organization has been able to improve quality of care while reducing per patient costs by 3.7%. Patient days on a ventilator, for instance, have been reduced by 26%, leaving fewer opportunities for infection and other uncomfortable side effects.

Growing Research and Education

Two years ago, the organization moved its research facilities to a separate location in downtown Seattle. “We are becoming a very large pediatric research hospital—ranked number five in NIH funding among the freestanding children’s hospitals in the US, up from number eleven last year,” says Hansen. Research funding jumped more than 40% in the last year.

Hansen says research is critical for moving forward. Before becoming CEO of Seattle Children’s, he spent about three-quarters of his time in a laboratory studying premature babies with lung disease. He believes research is the key to eliminating childhood diseases.

“We’re here to take care of all the children in our region, regardless of a family’s ability to pay. We’ll always be here. We also realize that our job is to do research for better treatment of pediatric disease and to educate the next generation of healthcare providers.”

-by Tracy Million Simmons

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