How Akron Children’s Hospital saved millions on construction and improved outcomes with Lean principles

In May, Akron Children’s Hospital unveiled its $180 million patient care facility, which was supposed to be its $240 million facility.

Among the features of the seven-story, 368,735-square-foot Kay Jewelers Pavilion are a new emergency department, a 75-bed neonatal intensive care unit, an expanded outpatient surgery center, and a labor and delivery center for high-risk births.

William Considine, the hospital’s president and CEO, says the decision to improve its facilities was made to support its clinicians and its expanding services.

Behind the scenes of the redesigned campus and state-of-the-art facility is the process the hospital used to build them. The process not only shaved money and time off the project, but has been a conduit for meaningful internal changes well before construction began.

Breaking out of silos

Lean principles were applied to the design of the facility to improve the delivery of services and squeeze more out of less space. It involved getting input from hospital staff, parents and even children. Sharing information, however, wasn’t always the hospital’s strong suit.

“I think what happens when you have silos is that certain good ideas don’t get shared,” Considine says. “People were hesitant to bring up something that might be viewed as them pointing the finger of blame.”

That, he says, made it hard to foster a culture of trust. With the aim of having transparency around discussions of quality, the hospital looked for ways to improve collaboration.

In 2007, Considine says Akron Children’s joined Solutions for Patient Safety Network, through which Ohio children’s hospitals could work together to improve pediatric health care across the state.

Sharing information led to real changes. For example, it reduced codes outside the ICU by 86 percent by simply empowering parents to ask for a medical response team if they saw that their child had taken a turn for the worse.

“So we had a lot of success with that,” Considine says. “Then we said, ‘OK, what else can we do?’ Let’s talk about adverse drug events. Let’s talk about surgical site infections. Let’s talk about central line infections. And we got our clinical teams together, and we started talking about those kinds of things, set some metrics, then we started sharing.”

The statewide initiative was so successful that Ohio received a grant from the Center for Medicare & Medicaid Innovation to take that model and expand it nationwide.