Improving Heart Surgery: Georgia Tech and Emory University Startup Receives $5.1 Million Investment

Apica Cardiovascular co-founders James Green, Vinod Thourani, Jorge Jimenez and Ajit Yoganathan (left to right) point to the location on a heart model where their heart surgery system attaches. (Credit: Gary Meek)

Apica Cardiovascular co-founders James Green, Vinod Thourani, Jorge Jimenez and Ajit Yoganathan (left to right) point to the location on a heart model where their heart surgery system attaches. (Credit: Gary Meek)

A Georgia Tech and Emory University medical device startup that has developed a system to simplify and standardize the technique for opening and closing the beating heart during cardiac surgery has received a $5.1 million investment.

Apica Cardiovascular has licensed the Georgia Tech/Emory technology and will further develop the system, which will make the transapical access and closure procedure required for delivering therapeutic devices to the heart more routine for all surgeons. The goal is to expand the use of surgery techniques that are less invasive and do not require stopping the heart.

“Our company has leveraged the expertise in cardiovascular technology at Georgia Tech and the clinical experience of surgeons at Emory University to develop a technology that has the potential to revolutionize the delivery of different types of medical devices to the heart, including aortic and mitral valves,” said the company’s CEO James Greene.

With research and development support from the Coulter Foundation Translational Research Program and the Georgia Research Alliance VentureLab program, the company has already completed a series of pre-clinical studies to test the functionality of their device and its biocompatibility.

The improved heart surgery system consists of a conduit with proprietary technology inside that allows the conduit to be securely attached to the beating heart. Surgeons can then deliver therapeutic devices, such as heart valves or left ventricular assist devices, into the beating heart without loss of blood or exposure to air. Once a therapeutic device has been delivered and surgery is complete, the company’s system closes and seals the access site with a biocompatible implant. The closure site can be reopened if necessary.

“By minimizing the incision size to gain access to the beating heart and eliminating the need for conventional sutures, our system improves safety, decreases procedure time and reduces the technical challenges associated with these new minimally invasive procedures,” explained Vinod Thourani, an associate professor of surgery and associate director of the Structural Heart Center in Emory University’s Division of Cardiothoracic Surgery.

With the new investment from Ireland-based Seroba Kernel Life Sciences and Israel-based TriVentures, the company will continue to conduct research and pre-clinical trials in Atlanta, ultimately leading up to regulatory approval. These efforts will be led by Jorge H. Jimenez, the chief technology officer of the company, which is in the VentureLab process at ATDC, Georgia Tech’s startup company accelerator.

“Our goal is to accelerate and expand the adoption of less-invasive therapeutic procedures to a greater number of surgeons and as a result, many underserved patients will receive needed treatment for valve disease and end-stage heart failure,” said Ajit Yoganathan, Regents professor and Wallace H. Coulter Distinguished Faculty Chair in Biomedical Engineering in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University.

The startup will also have an office in Ireland, which will benefit from the strong research collaborations between Georgia Tech, Georgia Tech Ireland and the National University of Ireland, Galway.

“We seek to contribute to and benefit from a global innovation ecosystem in ways that accelerate research results to the market while enhancing economic development opportunities here in Georgia,” said Stephen E. Cross, Georgia Tech’s executive vice president for research. “Apica Cardiovascular is a perfect example of the synergy between our leading edge work in Atlanta, our Irish translational unit GT Ireland, and our partnership with the National University of Ireland, Galway.”

Apica Cardiovascular was founded in 2009 based on technology invented by Jimenez, Thourani, Yoganathan and Thomas Vassiliades, who was an associate professor of cardiothoracic surgery at Emory University at the time. The company was named Emory University’s Startup Company of 2010.

About ATDC:

The Advanced Technology Development Center (ATDC) is a startup accelerator that helps technology entrepreneurs in Georgia launch and build successful companies. Founded in 1980, ATDC has graduated more than 120 companies, which together have raised more than a billion dollars in outside financing. In 2010, ATDC was named to Forbes Magazine’s list of the “10 technology incubators that are changing the world.”

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Writer: Abby Robinson

CardioMEMS Pioneers New Class of Implantable Monitoring Devices for Heart Patients

Atlanta-based CardioMEMS is pioneering a new class of monitoring devices for heart patients.  The company is based on Georgia Tech technology, and is located in Technology Enterprise Park.

Atlanta-based CardioMEMS is pioneering a new class of monitoring devices for heart patients. The company is based on Georgia Tech technology, and is located in Technology Enterprise Park.

CardioMEMS, a graduate of Georgia Tech’s ATDC startup accelerator, is a rising star in the medical device industry. Pioneering a new class of monitoring devices for heart patients, the company completed a successful clinical trial in May 2010 for its second product, which resulted in a $60 million equity investment and purchase option from St. Jude Medical Inc., a large medical device company based in St. Paul, Minn.

That investment earned the company a 2011 “Deal of the Year” award from Georgia Bio, a nonprofit association that represents Georgia’s pharmaceutical, biotech and medical device community

CardioMEMS, which has more than 65 employees, grew out of Georgia Tech research.

The company’s products combine wireless communications technology with microelectromechanical systems (MEMS) fabrication, providing doctors with more information while making monitoring less invasive for patients.

MEMS uses micro-machining fabrication to build electrical and mechanical systems at the micron scale — one-millionth of a meter. Using technology originally developed for the integrated circuit industry, MEMS is an attractive platform for medical devices because mechanical, sensing and computational functions can be placed on a single chip.

CardioMEMS began marketing its first product in 2006: the EndoSure sensor, which measures blood pressure inside a repaired abdominal aortic aneurysm. Implanted along with a stent graft during endovascular repair, this tiny sensor may allow doctors to monitor post-surgery patients more effectively than the CT scans that had previously been used. The EndoSure sensor is also less expensive and more convenient.

Now the company’s second product, a sensor that measures intracardiac pressure in people who suffer from congestive heart failure, is moving closer to FDA approval.

Implanted in the pulmonary artery, CardioMEMS’ new heart sensor enables Class III heart-failure patients (considered to be in the moderate stage of heart failure) to take daily intracardiac pressure readings at home. This information is transmitted to a website, which enables physicians to monitor patients more effectively and alter medications when necessary. In fact, results from the recent clinical study showed a 40 percent reduction in hospitalizations when doctors used data from CardioMEMS’ system to treat patients.

Launched in 2001, CardioMEMS was co-founded by Dr. Jay Yadav, a cardiologist and director at the Cleveland Clinic Foundation at the time, and Mark Allen, a professor in Georgia Tech’s School of Electrical and Computer Engineering and director of the school’s MEMS research group.

Due to the unique nature of its technology, CardioMEMS elected to locate in Atlanta to be close to Allen and his students. ATDC accepted CardioMEMS into its incubator program shortly after the startup’s formation.  The Georgia Research Alliance assisted with an industry partnership grant early in the company’s development.

“ATDC has played an important role in CardioMEMS’ success, especially during our early years,” said David Stern, CardioMEMS’ senior vice president for scientific affairs and one of the company’s first full-time employees.

 

Bioscience companies face unique challenges, Stern explained: They have greater needs for capital, face higher technical risks and typically need FDA or other regulatory approval before they can market their products or services. And unlike many entrepreneurs that can start their companies in a garage or home office, bioscience companies require special facilities.

CardioMEMS was among the first tenants in ATDC’s Biosciences Center, located within Georgia Tech’s Environmental Science & Technology (ES&T) research center, which enabled the company to access wet labs equipped with special ventilation and purified water systems. CardioMEMS was also able to use Georgia Tech clean rooms for micromachining.

If CardioMEMS had been required to build its own clean room, it would have cost millions of dollars and delayed R&D for months, Stern said. In addition, Georgia Tech’s clean rooms have a broad array of specialized equipment, which enabled CardioMEMS to execute its prototyping faster — and try different equipment to see what it would ultimately need to invest in.

The physical proximity to other entrepreneurs and researchers in ES&T was also a plus. “At one point we were next to another medical-device company, so it was easy for our staffs to have impromptu discussion walking down the hallways,” Stern said. Being on Georgia Tech’s campus gave CardioMEMS access to a deep talent pool, and enabled the company to hire professors as consultants, graduate students as permanent employees and current students as interns.

An important aspect of being able to use Georgia Tech facilities and hire talent was the lack of red tape. “With most institutions, that becomes very complicated and you can spend a lot of time negotiating contracts rather than getting work done,” Stern explained. “Yet ATDC was able to make it all really easy.”

“This may sound like a minor point, but it’s not,” said Stern, noting that startup is a crucial time for any company, but especially for a biotech firm. “It’s during those early years that you have the least amount of money — and the most to accomplish. You don’t want to waste time or money on anything that doesn’t involve progressing R&D or acquiring talent.”

Today CardioMEMS is located in Technology Enterprise Park, a biobusiness complex located south of the Georgia Tech campus, and FDA approval of its heart sensor would position the company for considerable growth. The heart sensor has faced a longer road to commercialization than the company’s first product, however, its market potential is dramatically larger, said Stern, citing a patient population of more than 1.5 million compared to about 30,000 for the EndoSure sensor.

Although CardioMEMS is already contributing to Georgia’s economy by generating new high-tech jobs, the company’s success has broader implications, observed Nina Sawczuk, ATDC general manager.

The $100 billion U.S. medical device industry is made up of thousands of small and medium-sized enterprises and a few large players. “Medical device companies are located throughout the country, but concentrated in specific regions known for other high-technology industries, such as microelectronics and biotechnology,” Sawczuk explained. “Georgia is among the top 10 states with the highest number of medical device companies and our focus is on supporting the small, innovative companies.”

To this end Georgia Tech has partnered with Saint Joseph’s Translational Research Institute, Piedmont Healthcare and the Georgia Research Alliance to launch the Global Center for Medical Innovation (GCMI), an initiative aimed at accelerating the development of next-generation medical devices and technology in the Southeast.

“CardioMEMS is a catalyst for developing a next generation medical-device industry hub in Georgia,” Sawczuk continued. “CardioMEMS marries MEMS technology with more traditional medical device technology. This is particularly exciting because the company is creating a new type of wireless product that is the future of the medical device industry. It is success stories such as CardioMEMS that the GCMI plans to replicate in the Southeast.”

Piedmont Fayette Reduces Length of Stay with Georgia Tech Assistance

U.S. emergency departments serve as the front door for more than half of all hospital admissions, resulting in long wait times, crowded conditions, and highly variable care and outcomes. In 2008, the average length of stay in U.S. emergency departments was four hours and three minutes. In Georgia, the statistics were slightly worse, ranking 34th out of the 50 states with an average wait time of four hours and 20 minutes.

The emergency department (ED) at Piedmont Fayette Hospital, a 143-bed facility located 30 miles south of Atlanta, was not immune to any of these modern health care challenges. According to Dr. Richard Mitchell, lean champion for Piedmont Fayette and subsequent chief medical officer, the average length of stay for patients that were treated and sent home was more than four and a half hours, as many as eight percent of patients were leaving without being seen and patient satisfaction scores were in the single digits.

“There was a lot of turmoil when we started,” he recalled. “Piedmont Hospital already had a contract with Georgia Tech to conduct lean projects to analyze and streamline flow processes, and Piedmont Fayette’s executive staff wanted us to look at processes in the emergency department.”

In July 2008, Jennifer Trapp-Lingenfelter of Georgia Tech’s Enterprise Innovation Institute helped train Piedmont Fayette staff in lean principles, an operational strategy that focuses on eliminating waste while increasing value-added work. Lean techniques improve profitability, customer satisfaction, throughput time and employee morale. The project began with a value stream map, a diagram used to analyze the flow of materials and information required to bring a product or service to a consumer.

“With detailed review of patient flow through ED, the first thing we realized was that the department was physically set up backwards. The sickest patients were being taken all the way through the department to the back of the ED and being placed in smaller rooms while the least sick patients were being seen right in front of the ED right off the ambulance entrance in an area that had previously been the hospital’s intensive care unit,” noted Trapp-Lingenfelter. “So the larger, more equipped rooms were being used for the lower acuity patients.”

To address this situation, the team re-assigned rooms and nursing stations so that the sickest patients are now placed in the large rooms at the entrance of the emergency department. The charge nurse was relocated from the front nursing station to be able to better manage incoming patients from the ambulance and reception areas.

In addition to changing the layout, separate patient flow teams were established for sickest, moderate and least sick patients. The least sick patients now go into an “express track,” where they can be examined by a physician assistant. Physicians are assigned to either the moderate or sickest track, and patients move through the system more smoothly and quickly.

“Before if we had two doctors and each took a very sick patient, the moderately-ill patients were waiting for more than two hours to be seen,” Mitchell said. “The basic idea was to keep that highway open for those moderate patients, so that when the ED starts getting clogged up with sicker patients, you can see them.”

As a result of these changes, the time in department for discharged patients dropped from four and a half hours to three hours and 45 minutes, a savings of 45 minutes per patient (32,850 hours annually) in spite of the hospital’s rising patient volumes. The percentage of patients leaving without being seen dropped from six percent to three percent, and patient satisfaction scores soared from the single digits to 64 percent.

The team also conducted a number of projects in 5S, a method for organizing the workplace. Often-used supplies had been stored in a room at the periphery of the department, were not labeled and were difficult to locate. After implementing 5S (sorting, straightening, sweeping, standardizing, and sustaining), supplies were moved to a central area and were color-coded and labeled in user-friendly language.

“Before the 5S project, supplies had been labeled in a totally incomprehensible way so no one could find anything in the supply room,” Mitchell said. “When we turned the nurses loose and let them sort stuff, they probably got rid of 40 percent of the supplies we had. By asking them how to set up the ED, they were being listened to and empowered.”

Tammy Estrada, director of emergency services, agrees that having front-line staff involved made all the difference in implementing the lean projects.

“We are constantly doing lean every week,” she observed. “We’ve been able to build on the projects that these guys did – the techniques and the principles – and now it’s a part of our language and a part of our culture.”

Mitchell acknowledges that the biggest challenge of the project was sustaining the changes and not getting frustrated when significant changes in the hospital’s metrics weren’t readily apparent.

“We had perfectly good changes, and they were the right changes, but we had difficulty sustaining them. What we were missing was the intense follow-up and the involvement of hospital leadership,” he recalled.

For three months, executive staff and emergency department leadership held nightly telephone conference calls to discuss what had happened each day and to reinforce management’s commitment to the project. According to Lisa Hedenstrom, vice president for patient care services and chief nursing officer for Piedmont Fayette, this is when the team started seeing quantifiable changes. They now hold bi-weekly update meetings.

“If you believe in shared governance and giving employees control over their work environment and decisions that they can make then this is a natural thing to do because it allows the people who are doing the work to have input into how the process works in a very systematic way where everyone is valued and appreciated,” she said. “It’s really given us a much better culture to promote patient care, thinking of how we can do things differently.”

In addition to implementing lean in the emergency department, the Piedmont Fayette team also examined a number of processes elsewhere in the hospital: post-surgery discharge, wheelchair access, supply cart storage, radiology test orders, IV pump cleaning, outpatient CT scans, pre-op patient paperwork and women’s services. As a result of these efforts, the time to process admit orders has dropped from 120 to 60 minutes, time spent searching for supply cart items has been cut in half, and turnaround time to clean IV pumps went from 24 hours to mere minutes. In addition, the number of misdirected radiology orders decreased from 15 to less than two per day, and 21 percent more outpatients can be seen with the same number of staff.

Through its Healthcare Performance Group, Georgia Tech project leaders work with healthcare professionals to conduct lean assessments, teach basic lean concepts, develop value stream maps to analyze the flow of materials and information, create quality systems and implement rapid process improvement projects.

About Enterprise Innovation Institute:

The Georgia Tech Enterprise Innovation Institute helps companies, entrepreneurs, economic developers and communities improve their competitiveness through the application of science, technology and innovation. It is one of the most comprehensive university-based programs of business and industry assistance, technology commercialization and economic development in the nation.

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Media Relations Contact: John Toon (404-894-6986); E-mail (ude.hcetag.etavonninull@noot.nhoj).

Writer: Nancy Fullbright

Improving Health Information: Georgia Tech To Support Deployment of Electronic Health Records

Improving Health InformationThe Georgia Institute of Technology is part of a new statewide effort aimed at facilitating the adoption of secure and confidential electronic health record systems by primary-care providers – especially those that reach underserved portions of the state’s population.  The goal of the effort is to apply a community-oriented approach to outreach, education and technical assistance facilitating the adoption and “meaningful use” of the electronic health records.

The work is part of a $19.5 million federally-funded project – headed by the Morehouse School of Medicine’s National Center for Primary Care (NCPC) – to help primary-care providers in smaller practices adopt comprehensive electronic health record (EHR) systems.  The project is being coordinated by the Georgia Health Information Technology Regional Extension Center (GA-HITREC).

Georgia Tech is also helping establish a group purchasing program that health care providers can use to more simply and easily obtain their EHR software.

“The ultimate goal is higher quality, more cost-effective health care for Georgia,” said Stephen Fleming, a Georgia Tech vice president and executive director of its Enterprise Innovation Institute, which will provide the services.  “This will not only benefit individual citizens of the state directly, but will also make Georgia more attractive to companies of all sizes because health care costs are often the second-largest expense, after payroll, for business and industry across the board.”

The Georgia Tech Enterprise Innovation Institute (EI2) will receive approximately $2.8 million for its contributions to the project.

The GA-HITREC project will help as many as 5,200 primary-care providers in smaller practices select electronic health record systems, properly install the software and implement new workflow processes that achieve meaningful use of the technology.  Using its existing statewide network of regional technical assistance offices, Georgia Tech will be among several organizations providing direct support to providers as they adopt the technology.

“The effort will include an assessment tool to help determine what each provider practice needs to do to achieve meaningful use as defined by the U.S. Department of Health and Human Services.  This would include education and training, changes in clinical and administrative processes, addressing computer hardware and facility issues, and providing connectivity to emerging health information exchanges,” explained Steve Rushing, director of Georgia Tech’s health@ei2 program.  “Staff from the Enterprise Innovation Institute will conduct one-on-one and group presentations to explain electronic health records, assist in selecting EHR products and conduct follow-up to ensure that new systems are meeting the mandated criteria.”

Some $20 billion in funding through the “Health Information Technology for Economic and Clinical Health Act” (HITECH) will support similar programs nationwide to encourage the deployment of interconnected electronic health records.  Funding for the program is from the American Recovery and Reinvestment Act (ARRA) of 2009.

“The widespread adoption and meaningful use of EHRs can significantly impact the gaps in disparities among our nation’s communities,” said Dr. Dominic Mack, director of GA-HITREC and deputy director of the National Center for Primary Care.  “A major goal of the federal initiatives is to put underserved communities on an equal playing field when it comes to health information technology (HIT).  I think with valuable partners such as Georgia Tech, we are on the right path.”

The Office of the National Coordinator for Health Information Technology (ONC) was established by executive order in 2004 with the goal of laying the policy and standards groundwork for such a nationwide health records system.  The objectives are to cut $10 billion per year from the government’s health care costs, and to generate additional savings through improvements in quality of care and care coordination, and through reductions in medical errors and duplicative care

Across the United States and in Georgia, use of comprehensive electronic health records systems is currently limited, with less than 10 percent of hospitals and doctors using networked systems able to provide meaningful support for higher quality care.  Over the coming decade, the U.S. Office of Management and Budget expects that initiatives such as the Morehouse program will boost usage of the systems to 90 percent for doctors and 70 percent for hospitals.

“A comprehensive electronic health records system is important for the long-term management of chronic health problems such as diabetes and heart disease,” said Mark Braunstein, assistant director of the Health Systems Institute, a program operated jointly by Georgia Tech and Emory University.  “As much as 75 percent of U.S. health care dollars now pay for this type of care, and without adoption of technology for more coordination of care, that cost will continue to grow as the population ages.”

Care for chronic diseases takes place over years, is often provided by many different sources and – ultimately – the outcome depends heavily on patient behavior.

“We need health information infrastructure that will allow every doctor to know what other providers are doing to efficiently and effectively care for a patient with chronic disease,” Braunstein explained.  “If most physicians are still using paper records, this will be virtually impossible.”

By adopting electronic records capable of so-called “meaningful use,” the initiative will also help doctors stay current with new information on the best and most cost-effective methods.

“With the rapid advances in medical knowledge, it is very difficult for physicians – particularly rural primary-care physicians who must treat virtually all medical problems in their communities – to keep up,” Braunstein noted.  “Helping every physician successfully adopt technology that can help them stay current is a top priority.”

In a study released earlier this year, EI2 also documented that the state’s health information technology industry includes more than 100 companies and employs approximately 10,000 people.  Investments in electronic health record systems will therefore have an additional economic development benefit beyond helping control health care costs.

“Georgia businesses stand to benefit substantially from this national investment in health information infrastructure,” Fleming noted.

CAPTION: Electronic health record systems improve access to patient information, such as test results.  Here, Dr. Mark Cohen, the Chief of Quality, Informatics and Information Technology for The Piedmont Heart Institute, discusses the results of an electrocardiogram with Michelle McElwee.

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Medical Innovation: New Device Center Wins $2.6 Million in Funding

Medical Innovation

The Southeast’s first comprehensive medical device innovation center has been awarded a total of $2.6 million to build and equip a prototyping design and development facility that will accelerate the commercialization of next-generation medical devices and technology.

The Global Center for Medical Innovation (GCMI) will receive $1.3 million from the Economic Development Administration, which is part of the U.S. Department of Commerce. That money will be matched by $1.3 million from the Georgia Research Alliance (GRA), a public-private organization that supports development of technology industry in Georgia.

GCMI is a partnership of four of Georgia’s leading research and health care organizations: the Georgia Institute of Technology, Saint Joseph’s Translational Research Institute (SJTRI), Piedmont Healthcare, and the GRA. The Center will bring together the core members of the medical device community, including universities, research centers and clinicians; established drug and device companies; investors, and early-stage companies.

“One of Georgia’s major research strengths is the ability to bring engineering together with the biosciences to create new solutions for health care problems,” said Stephen E. Cross, executive vice president for research at Georgia Tech. “The Global Center for Medical Innovation will help move innovations from the laboratory through the functional prototype stage, while coordinating the other commercialization activities necessary to bring them to market.”

To be located in an existing building on 14th Street near the Georgia Tech campus in Atlanta, the new facility will advance innovations that can be the basis for new products and new life-science companies. By providing comprehensive support services in one location, the Center will reduce the cost of developing and converting innovations into functional prototypes and clinical products.

“Investments being made in Georgia’s research universities are creating the knowledge and innovation needed to grow our medical device industry,” noted Mike Cassidy, president and CEO of the GRA. “We are supporting GCMI because it will help convert this knowledge and innovation into commercial products that will create jobs, new investments and new companies for Georgia.”

The Economic Development Administration expects the center to generate $72 million in new investments and create or save 161 jobs.

The grants will support renovation of the facility to house design, material and mechanical engineering resources, along with state-of-the-art rapid and functional prototyping equipment capable of producing a wide range of medical devices for development, pre-clinical testing and clinical studies. Within the next two months, the Center will request proposals and bids for architectural and engineering services needed for the new facility.

Because of the research strengths of the participating institutions, the Center’s initial focus will be on cardiology, orthopedics and pediatrics.

“Medical device companies in the Southeast have long been at a disadvantage compared to competitors elsewhere that have access to long-established support networks,” said Nicolas Chronos, M.D., president of the Saint Joseph’s Translational Research Institute (SJTRI-Atlanta). “This new center will help level the playing field, creating a single entity that will work with companies on comprehensive development activities. It will also provide a single location for investors seeking qualified medical device companies, and allow innovations created by multiple institutions to be combined to create more useful devices.”

Projects developed in the Center could be hosted at SJTRI’s new 18-bed, hospital-based facility for phase one and “first in human” testing. The facility, scheduled to open in July, will focus on industry and government translational projects.

Bringing together physicians who have experience in treating patients with scientists and engineers on the cutting edge of technology will facilitate the development of revolutionary new devices that meet real-world medical needs.

“Physicians who treat patients every day have a very real understanding of the need for new technology, but they usually lack the resources to translate their ideas and solutions into new medical devices,” said Jay S. Yadav, M.D., a cardiologist with Piedmont Heart Institute Physicians and CEO of Atlanta medical device company CardioMEMS. “By working with our partners in GCMI, we can meet the needs of our patients while creating new business opportunities.”

Obtaining financing for new products and new companies is always a challenge for medical device innovators. The new Center will help advance device and technology innovations far enough to interest investors.

“With the difficult economy and increasing pressure to minimize risk, few investors or potential partners are willing to consider new medical device concepts without working prototypes that have undergone rigorous development and pre-clinical testing,” noted William Schaeffer, a consultant working with GCMI. “The new prototyping center will offer the equipment and services necessary to bring new devices and technology to the stage at which they can attract interest from investors.”

GCMI grew out of a decade or more of experience commercializing discoveries from laboratories at the partner institutions.

“For many years we have seen the need for a prototyping center that would provide medical device innovators with the support they need to quickly bring new innovations to market,” said Wayne Hodges, executive director of the Center. “Our new facility will allow intellectual property developed in Atlanta, Georgia and the Southeast to remain here and provide long-term benefit as these innovations move into new products and new companies.”

While the Center is being organized by Atlanta-based organizations, it is expected to attract device developers from the Southeast, strengthening Atlanta’s role as a hub for medical technology development.

“We believe that this new facility will help expand the nucleus of medical device companies already here, making metro Atlanta, the state of Georgia and the Southeast a new hub for the world’s medical device industry,” Schaeffer added.

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Georgia Tech Students Sweep Health IT Coding Challenge

Key to the future efficiency of the United States’ health care system is effective implementation of new technologies, such as electronic medical records (EMRs), as well as dovetailing those technologies with the human care and decision-making that is so critical to good medicine.

Example: Physicians who are on call—meaning, literally, positioned to provide care and direction via telephone—invariably must respond to patients they’ve never met. The information at hand may be the patient’s own description of symptoms and perhaps the data contained in an EMR. How should such a data set be presented to the doctor to maximize the speed and effectiveness of care?

A team of Georgia Tech College of Computing graduate students recently accepted that challenge—and delivered in a big way. Calling themselves the Georgia Tech Flatliners, the group finished first, second and third at the CONNECT Code-a-Thon Challenge, held April 28-29 in Miami.

“New ideas and new approaches for health care information technology are among the most critical challenges facing the United States today,” said Stephen Fleming, Georgia Tech vice president and executive director of the Georgia Tech Enterprise Innovation Institute. “Georgia Tech’s understanding of information technology and its knowledge of the health care industry provide a unique perspective on this challenge. The success of these students demonstrates that Georgia Tech can play an important role in addressing critical needs in this area.”

The Code-a-Thon asked teams to create innovative stylesheets to display the information in a continuity of care document (CCD) to a primary care physician taking calls from patients after office hours. The idea is to develop a CCD visualization tool that facilitates an efficient and effective phone consultation between the on-call doctor and an unfamiliar patient. Not only did the solutions have to transfer data error-free, but the graphic user interface had to translate across multiple platforms (mobile phone, netbook, full-size screen, etc.) and allow for the most efficient use of the physician’s time.

The GT Flatliners, consisting of computer science Ph.D. student Klara Benda and master’s students Adrian Courreges, Monosij Dutta-Roy and Hassan Khan, presented three solutions: a problem-based approach, a rapid-information-access approach and a multi-context approach. The three solutions finished No. 1, No. 2 and No. 3 in the contest—which was not limited to just students. The Flatliners also competed against working professionals in health IT. Here’s what they came up with:

• Problem Oriented Approach (winner): arranged the clinical data by problem so that the physician could hone in on relevant information to the particular problem the patient is presenting.
• Multi-Context Approach (second place): provided a highly flexible visual display that allows the physician to arrange information according to his or her particular “mental model” for handling a particular problem.
• Rapid Access Approach (third place): provided quick and easy navigation among all of the clinical areas in which data is stored in the CCD.

The College of Computing, together with colleagues across Georgia Tech, is making a big push into the grand challenge of health IT. In 2004 President George W. Bush signed an executive order calling for the creation of a national health information infrastructure; by 2015, all Americans will have a digital CCD. Thus solutions like those provided by the College of Computing team will be critical to maximizing the efficiency of those records. Indeed, all three Flatliner solutions are now available for free download and use through Open Health Tools (OHT), an open source community for health IT.

“If the country is going to make full use of technology in improving the efficiency of our health care system—and getting a handle on the enormous costs it currently demands—it’s going to take the effort and ingenuity of everyone in the health IT community,” said Professor Mark Braunstein, who taught the health informatics class in which the Flatliner team was enrolled. “I’m tremendously proud of our students for coming up with such innovative solutions to this problem, and I’m thankful to the people and organizations we’ve partnered with to bring these solutions into the open source community.”

Sponsored by the National Health Information Network, the Code-a-Thon Challenge was hosted by Florida International University, OHT and the American Academy of Family Physicians National Research Network. For more information, visit the contest’s website: http://hit.fiu.edu/challenge.htm

Media Relations Contact: Stefany Sanders (404-312-6620); E-mail: (ude.hcetag.ccnull@ynafets).

Georgia Tech Helps Piedmont Newnan Improve Accuracy, Decrease Turnaround Times

The cross-functional team at Piedmont Newnan was made up of employees that deal with the process daily. For this project, they focused on case carts, which are used for pulling together all supplies needed for surgical procedures.

Pam Murphy, a registered nurse and director of surgical services at Piedmont Newnan Hospital, has seen it all in her 23 years of employment at the hospital.

In 2007, when the hospital was chosen as a pilot site for a lean implementation for the Piedmont Healthcare System, she knew that participation from the hospital’s staff would be critical. She also knew there would be a concern that lean – a methodology that aims to eliminate waste – would mean doing more with less.

“A lot of staff members first thought that we were just trying to get efficient so we could eliminate positions. We had to assure them that this was not the case; we just wanted to be as efficient as we could be so we could build the business,” she recalled. “The hard part for an organization is committing the resources, something especially difficult in healthcare. Once you do that, however, you can attack the issue in one week and come up with solutions.”

The focus of Piedmont Newnan’s process improvement project was the six operating rooms on its main campus. Jennifer Trapp-Lingenfelter and Kelley Hundt of Georgia Tech’s Enterprise Innovation Institute helped train Piedmont staff in lean principles, an operational strategy that focuses on eliminating waste while increasing value-added work. Lean techniques improve profitability, customer satisfaction, throughput time and employee morale.

“We knew that the turnaround time on the operating rooms was our biggest issue, but when we did the value stream map that outlined the entire process, we decided to tackle something we knew could make a big difference,” said Murphy. “We decided to focus on the case carts, which are used for pulling together everything that we need for a surgical procedure.”

The case cart project began in December 2007 with an introduction to lean principles. According to Trapp-Lingenfelter, at least 90 percent of the OR staff had received basic lean training by the end of the project, a critical component of the success. A cross-functional team composed of nurses, surgical technologists and central service personnel went to the OR and the central sterilization department to observe the case cart process and note which steps were value-added and which ones involved waste.

Prior to the lean implementation, the case cart accuracy at Piedmont Newnan was approximately 50 percent. The team observed that there was no formal scheduling process for the central sterilization department, no designated person to pull together case carts, no standard process to pull the case carts and a lack of labeling and organization. These issues led to a significant amount of re-work.

After the team analyzed the process, it identified solutions that could be implemented that same week – such as 5S, a method for organizing the workplace. The team developed a new standard case cart design, labeled cabinets and carts, established parking spots for case carts, defined the path for picking items that go in the carts, alphabetized instruments, designated a return bin for unused supplies, centralized the case cart picking tools and set a minimum inventory level for all instruments. Now all case carts are pulled the day of a procedure, with the exception of 7:30 a.m. surgeries pulled the afternoon before. In addition, missing items are highlighted in yellow, the standard picking procedure is posted and one person is assigned the responsibility of picking the case carts.

“Before the lean process, whenever we had down time we would tell staff to pull case carts for the next day. They would begin to look down the list and see items that were currently in use or needed to be in use that afternoon, so we would end up with case carts that were missing instruments,” Murphy noted. “As a result of this project, we realized that our computer system would allow us to see where equipment was, so we built a location into everything. Now, if I gave you a card with a list of items that needed to be pulled for a surgery tomorrow, you could go pull everything even if you had never been in my OR before.”

As a result of the lean implementation, case carts can now be pulled in five minutes versus 20 minutes before and the overall case cart accuracy has risen from 50 percent to 98 percent. Supply items that need to be available on case carts but which may not be used with all procedures are only opened if needed, reducing waste. The bins have yielded a projected savings of $118,000 annually.

“The success of the case cart project was a win-win, so when we decided to tackle turnaround times, we had buy-in from the staff and they had already been educated on the process,” said Murphy.

In this project, the team developed a process that defined roles, responsibilities and visual controls to reduce the time required to clean and prepare an operating room for a new procedure. Prior to the implementation, the average turnaround time for patient out to patient in was 19 minutes; it now averages 14 minutes. Physician turnaround time went from 51 minutes to 40 minutes. Piedmont Newnan has also been able to increase its percentage of on-time procedure starts and decrease after-hours cases and resulting overtime pay. Moving forward, the team will set goals specific to each specialty.

The projects at Piedmont Newnan were so successful that they were recognized by VHA Georgia, part of the national healthcare alliance, VHA Inc. Last year, 10 Georgia hospitals were recognized for improving their supply chain performance, clinical care, operational efficiency and community benefit performance. Piedmont Newnan Hospital was selected as a winner of the 2008 VHA Inc. Georgia Regional Leadership Awards in the Operational Excellence category for improvements in the operating room that increased patient care and improved patient and physician satisfaction.

“Sustainability is probably the hardest part because you have to be willing to commit to it. If you conduct a 5S procedure on an area and then let it go, it’s going to end up looking like your junky kitchen drawer again,” Murphy observed. “Having someone come in from the outside gets you to think about how things can be done differently. Having another set of eyes that aren’t familiar with your process helps you open your eyes and see ways to make improvements.”

Through its Healthcare Performance Group, Georgia Tech project leaders work with healthcare professionals to conduct lean assessments, teach basic lean concepts, develop value stream maps to analyze the flow of materials and information, create quality systems and implement rapid process improvement projects. For more information on healthcare performance improvement services offered by Georgia Tech’s Enterprise Innovation Institute, contact Jennifer Trapp-Lingenfelter (404-386-7472) or (ude.hcetag.etavonninull@retlefnegnil.nnej).

About Enterprise Innovation Institute:
The Georgia Tech Enterprise Innovation Institute helps companies, entrepreneurs, economic developers and communities improve their competitiveness through the application of science, technology and innovation. It is one of the most comprehensive university-based programs of business and industry assistance, technology commercialization and economic development in the nation.

Research News & Publications Office
Enterprise Innovation Institute
Georgia Institute of Technology
75 Fifth Street, N.W., Suite 314
Atlanta, Georgia 30308 USA

Media Relations Contact: John Toon (404-894-6986); E-mail (ude.hcetag.etavonninull@noot.nhoj).

Writer: Nancy Fullbright

Piedmont Newnan Hospital and Georgia Tech Present at National Conference

Pam Murphy, director of surgical services at Piedmont Newnan Hospital, and Jennifer Trapp-Lingenfelter, a project manager for Enterprise Innovation Institute, talked to surgical leaders about how to facilitate lean projects and sustain improvements.

More than 75 surgical services leaders across the country recently heard about how Piedmont Newnan Hospital was able to decrease its turnaround times by 30 percent and increase case cart accuracy to 100 percent with a little assistance from Georgia Tech. Pam Murphy, director of surgical services at Piedmont Newnan Hospital, and Jennifer Trapp-Lingenfelter, a project manager for Georgia Tech’s Enterprise Innovation Institute EI2, presented at a workshop at the OR Manager conference in Las Vegas, Oct. 7. The six-hour workshop, “Implementing Lean in the OR,” explained how operating rooms can facilitate lean projects and, more importantly, how to sustain the improvements.

Lean is the practice of evaluating the steps of a process to determine the cost-value added to a final product or service. It seeks to minimize the resources required for production by eliminating waste that inflates cost and turnaround times, and decreases efficiency.

Piedmont Newnan began working with Georgia Tech in December 2007 with an introduction to lean principles. According to Trapp-Lingenfelter, at least 90 percent of the operating room staff had basic lean training by the end of the project, a critical component of their success. The cross-functional team comprised of nurses, surgical technologists and central service personnel who went to the OR and the central sterilization department to observe the case cart process and note which steps were value-added and which ones involved waste.

“A lot of staff first thought that we were just trying to get efficient so we could eliminate positions. We had to assure them that this was not the case; we just wanted to be as efficient as we can be so we can build the business,” recalled Murphy. “The hard part for an organization is committing the resources, something especially difficult in health care. Once you do that, however, you can attack the issue in one week and come up with solutions.”

As a result of the lean implementation, case carts can now be pulled in five minutes versus 20 minutes and the overall case cart accuracy has risen from 50 percent to as high as 100 percent. Whereas staff would open all supplies prior to this project, they now refer to “do not open” bins, items that may be used in a case but do not need to be opened until that time. The bins have yielded a projected savings of $118,000 annually. Piedmont Newnan has also been able to increase its percentage of on-time procedure starts and decrease after-hours cases.

Through EI2’s Healthcare Performance Group, project leaders work with healthcare professionals to conduct lean assessments, teach basic lean concepts, develop value stream maps to analyze the flow of materials and information, develop quality systems and implement rapid process improvement projects. For more information on healthcare performance improvement services offered by Georgia Tech’s Enterprise Innovation Institute, contact Jennifer Trapp-Lingenfelter, Healthcare Performance Group (404-386-7472); E-mail: (ude.hcetag.etavonninull@retlefnegnil.nnej).

About Piedmont Newnan Hospital:

Piedmont Newnan Hospital (PNH) is a 143-bed, acute-care hospital in Newnan, Georgia, offering 24-hour emergency services, women’s services and general medical/surgical services. Diagnostic services include CT, nuclear medicine, MRI, PET, ultrasound and fluoroscopy. A complete range of medical/surgical services includes laparoscopic surgery, physical therapy, respiratory therapy, sleep studies and cardiac catheterization and rehabilitation. With approximately 856 employees and a medical staff of over 150 physicians, PNH is a member of Piedmont Healthcare (PHC), a not-for-profit organization that also includes Piedmont Hospital, a 481-bed acute tertiary care facility offering all major medical, surgical and diagnostic services located on 26 acres in the north Atlanta community of Buckhead; Piedmont Fayette Hospital, a 143-bed, acute-care community hospital located on Highway 54 in Fayetteville; and Piedmont Mountainside Hospital, a 42-bed community hospital in Jasper. Piedmont Healthcare also is the parent company of the Piedmont Heart Institute (PHI), which combines more than 75 cardiovascular specialists in Piedmont Heart Institute Physicians with over 30 locations across north Georgia, and the Fuqua Heart Center of Atlanta at Piedmont Hospital; Piedmont Philanthropy, the philanthropic entity for private fundraising initiatives; the Piedmont Physicians Group, with more than 100 primary care physicians in over 30 offices throughout metro Atlanta; and the Piedmont Clinic, a 600-member physician network. For more information, visit piedmontnewnan.org.

About Enterprise Innovation Institute:

The Georgia Tech Enterprise Innovation Institute helps companies, entrepreneurs, economic developers and communities improve their competitiveness through the application of science, technology and innovation. It is one of the most comprehensive university-based programs of business and industry assistance, technology commercialization and economic development in the nation.

Research News & Publications Office
Enterprise Innovation Institute
Georgia Institute of Technology
75 Fifth Street, N.W., Suite 314
Atlanta, Georgia 30308 USA

Media Relations Contact: John Toon (404-894-6986); E-mail (ude.hcetag.etavonninull@noot.nhoj).

Writer: Nancy Fullbright



Athens Hospital Improves Processes by Implementing Lean in Laboratory

As part of the lean implementation, team members removed sliding doors from shelving and doors from storage cabinets to easily identify supplies.

Debbie Guzman, laboratory director at Athens Regional Medical Center, says that implementing lean principles in a health care setting is especially challenging. Traditionally used in manufacturing, lean refers to an operational strategy derived from the Toyota Production System that focuses on eliminating waste while increasing value-added work to improve profitability, customer satisfaction, throughput time and employee morale.

“People involved in health care are about hands-on care-giving, comforting and healing,” she said. “We needed someone to help us who understood our language.”

Fortunately, Guzman found an excellent translator in Georgia Tech’s Enterprise Innovation Institute. Through its Healthcare Performance Group, project leaders work with health care professionals to conduct lean assessments, teach basic lean concepts, develop value stream maps to analyze the flow of materials and information, develop quality systems and implement rapid process improvement projects.

“We wanted the Healthcare Performance Group to provide the training, the structure and the facilitation for a period of time to do a 5S project in the lab. By using the 5S system – sort, straighten, shine, standardize and sustain – we thought we could significantly improve the efficiency and effectiveness of the laboratory,” explained Jim Pirkle, Athens Regional’s associate director of quality services. “Originally we were going to begin the project in one area, but we wanted each of the section supervisors to be involved so it could be a whole lab culture change.”

After years of inventory accrual and process adaptation, the five sections of the lab – pathology, chemistry, hematology, microbiology and blood bank – were in a physically dysfunctional environment. As the hospital expanded, team members had the opportunity to design a new lab that had the right supplies next to the right instruments, the appropriate amount of storage and counter space, equipment set up to facilitate testing processes and work processes arranged to minimize excess steps.

“We wanted to address inventory control – having the right inventory in the right place and at the right time,” said Frank Mewborn, leader of the Healthcare Performance Group. “An example that everyone could understand and relate to was gloves. We had the team estimate the glove inventory and then we actually counted it. We found open boxes and unopened boxes all around the lab. The inventory was three times higher than the team predicted. It was an eye-opening exercise.”

While the overall goal was to help design a highly-functional lab, the immediate project goals included making workspace more efficient, reducing inventory and supply costs, decreasing process steps and complexity and creating efficiencies in a timely manner. Participants included the lab director and supervisors, lab staff and quality support staff from Athens Regional, as well as Mewborn, Tara Barrett and Kelley Hundt from Georgia Tech. Five teams of 21 people learned about lean and 5S methodologies, participated in brainstorming and planning exercises and completed an “eye-opening” walk-through of the entire laboratory.

“Typically when we do a project like this, we do it in a series. We’ll pick one small area of the lab and get it really ship-shape and then use it as a model for the next area,” Mewborn recalled. “But Debbie wanted this to be a culture change in addition to a procedural change so we did all five areas simultaneously.”

In the first phase of the project, team members sorted the useful from the unnecessary. They evaluated the necessity of all supplies and equipment, cleared away trash and outdated equipment from the area and removed sliding doors from shelving and doors from storage cabinets to easily identify supplies. Most importantly, each department developed a systematic and collaborative process for sorting obviously misplaced items from useful ones.

Team members also relocated supplies, acquired supply bins and consolidated storage areas; set up a standard visual inventory system with red and green tape and developed kanban cards to display the name of the supply, the name of the supplier, the desired number of units and the item’s reorder point; and cleared trash away from the work area, thoroughly cleaned countertops, drawers and cabinets and removed redundant and unnecessary signage. Moving forward, Athens Regional has established a committee to focus on sustaining these improvements.

“Employees say this is now a much better place to work, and there is not as much clutter or confusion. In regards to patient safety, that’s a significant benefit,” Pirkle said. “As a result, we’ll have better patient outcomes as we become more accurate and timely.”

In particular, the 5S project increased the lab’s storage capacity by 64 percent, freed up counter space by 30 percent and reduced body fluid processing times from 12 to four minutes. Other results include reduced inventory and supply costs, decreased stock on hand, and greater clarity in the lab environment. Projected savings from reduced steps and time to complete work total more than $15,000.

“When the process is really lean, when you walk through the lab things are in their place. Everything is in the front and one person can go through the lines and know what needs to be ordered,” Guzman noted. “The biggest benefit of the project is that we now have some real lean champions in the lab.”

For more information on health care performance improvement services offered by Georgia Tech’s Enterprise Innovation Institute, contact Jennifer Trapp-Lingenfelter (404-386-7472); E-mail: (ude.hcetag.etavonninull@retlefnegnil.nnej).

About Enterprise Innovation Institute:
The Georgia Tech Enterprise Innovation Institute helps companies, entrepreneurs, economic developers and communities improve their competitiveness through the application of science, technology and innovation. It is one of the most comprehensive university-based programs of business and industry assistance, technology commercialization and economic development in the nation.

Research News & Publications Office
Enterprise Innovation Institute
Georgia Institute of Technology
75 Fifth Street, N.W., Suite 314
Atlanta, Georgia 30308 USA

Media Relations Contact: John Toon (404-894-6986); E-mail (ude.hcetag.etavonninull@noot.nhoj).

Writer: Nancy Fullbright

Newnan Hospital Partners with Georgia Tech to Implement Lean

This article is reprinted from OR Manager, Vol. 25, No. 5, May 2009.

When Pam Murphy, RN, director of surgical services at 144-bed Piedmont Newnan Hospital in Newnan, Georgia, first heard a Lean presentation, she says, “It made sense, because we are so process driven. The whole focus is, ‘What is touching the patient, and what is value added?’”

Piedmont Newnan’s ORs were the pilot site for a Lean project for the Piedmont Healthcare system. The hospital has 8 ORs on 2 campuses. Piedmont was aided by Georgia Tech’s Enterprise Innovation Institute in Atlanta.

Developed by Toyota, Lean in health care brings clinicians and other staff together to improve processes that waste time and resources.

Involving the staff

Murphy knew the staff’s participation would be critical. She also knew they would have a concern: Does Lean mean doing more with less? Would people lose their jobs?

Backed by the administration, Murphy assured them no one would lose their jobs because of Lean.

Another concern—with staffing tight, how do you get staff off to participate in a project? How might that affect productivity numbers?

Again, Murphy had top-level support. A Lean account was set up for charging employees’ time so managers wouldn’t be penalized for lower productivity.

“That was a key decision by the executive team,” says Jenn Lingenfelter, project manager for Georgia Tech’s Health Care Performance Group, who worked with Piedmont Newnan.

Getting started

Since the Lean project started in December 2007, the ORs have conducted two 5-day Lean rapid process improvement (RPI) projects (also called kaizen events), one on case carts and the other on turnover time.

The hospital wanted to start with turnover time, but Lingenfelter urged the team to step back and take a wider view of the surgical process. In doing so, they realized one issue affecting turnover time was that case carts weren’t available and supplied correctly, which meant rework before cases.

Murphy recognized that if she and the staff could improve the case cart process, they would attract buy-in from other staff and physicians and build momentum for other projects.

These are the steps they took.

Training for staff

In Lean, improvement initiatives bubble up from the front lines, so the staff is critical to Lean. Lingenfelter began by introducing managers and an initial group of staff to Lean. By the end of her involvement, 90% to 100% of the OR staff had basic Lean training.

Selecting a team

For the case cart RPI, a cross-functional team of front-line OR staff was selected, including nurses, surgical technologists (STs), and central service (CS) personnel.
Murphy had planned for coverage 6 weeks ahead by arranging for per diem staff and having other staff report earlier in the day.

‘Going to the gemba’

After an introduction to Lean, the RPI team went to the OR and CS departments to observe the case cart process. In Lean, this is called “going to the gemba”—going to where the actual work is done. Getting the team out of their daily routine helps them to spot activities that waste time and energy.

The team split up to observe the instrument flow in the CS department, case-cart picking, and the opening of case carts and setup in the OR. They gathered baseline data by timing how long it took to pick a case and assemble a case cart.
The observers helped pique interest of the rest of the staff.

“The team would say, ‘This is what we’re looking at. What do you think?’ That helped to spread the excitement,” Murphy notes.

Mapping the process

After the observations, the team met in a conference room to map out the process on the wall. They noted which steps were value added and which involved waste.

Themes emerged:
• The preference lists were in reasonable shape but needed tweaking. The lists are computerized but didn’t include locations where supplies were stored.
• There was not a formal way of picking a case.
• The staff didn’t trust one another to pull cases accurately because everyone did it in a different way.
• Items were not placed in standardized locations on the case carts.
• In the OR, many items were opened “just in case” instead of held in reserve, as indicated on the preference list. That caused a lot of waste.

Whirlwind of improvements

The team divided into smaller teams to tackle each issue.

“We prioritized ideas and focused on those we could do that week. It was like a whirlwind,” Lingenfelter says.

One focus was a standardized case-picking method.

“In manufacturing, a distribution center is arranged so you go down Aisle 1 and pick items, then you go to Aisle 2, and so forth. With the case carts, staff were zig-zagging and backtracking,” she says.

The team worked with the IT department to develop a systematic pick path.

The preference lists were standardized to mirror the layout of the supply room so the person pulling a case would always start in the same location. Another breakthrough was to eliminate pulling all of the cases the day before. That had caused some case carts to be incomplete, meaning rework to look for supplies before a case and “stealing” from case carts already pulled.

Instead, the team decided that the only cases pulled the day before would be the first cases of the day. That reduced the space needed for case carts and eliminated incomplete case carts. The staff’s biggest concern was that case carts would not be ready, but Murphy says that has not been an issue.

A standard arrangement

The team also developed a standard arrangement of items on the cart so items needed first are on the top shelf and so forth. Other changes were:
• entering supply locations on the preference cards
• labeling shelves and bins in the automated supply cabinets
• cautioning staff not to pull cases from memory but to use the preference cards—even if they had been there for 20 years.

Updating preference cards

The team also fine-tuned the process for updating preference cards:
• The person picking the case prints out the preference card and highlights any missing items, such as an instrument set still in CS.
• The preference card goes with the case cart to the OR.
• In the OR, the OR staff write any missing items on the preference card.
• After the case, the preference card is taken to a designated location. The cards are tallied for missing items to determine an accuracy rate.
• Preference cards needing changes are transferred to another box where one person does the updates, typically within 2 or 3 days.

An ‘aha moment’

The RPI’s biggest win and greatest savings came from an “aha moment” during the observations.

“We found people had gotten into the habit of opening everything for a case,” Murphy says, even items labeled on the preference card as “do not open unless needed.”

In an easy fix, a “do not open” bin was added to the case carts. All such supplies for a case are placed in the bin when a case is picked. After the case, the bin with any unopened supplies goes back to CS with the case cart, and the supplies are restocked.

The savings—$118,000 over a year.

After the RPI, the overall case cart accuracy rate rose from 50% to 98% accuracy to 100% accuracy in November and December 2008, Murphy says.

Keeping up the momentum

Lean is meant to be a cultural change, not a short-term project. How do you keep it going?

“You have to continue to monitor and measure. Otherwise, the staff loses sight of where they are,” Murphy says. She reports the preference card accuracy rate to the staff regularly.

The spirit of Lean needs to become part of everyone’s thinking, Murphy notes.

Many of the staff have been involved in Lean projects.

“The only reason we succeeded was because of the staff,” Murphy says. “The staff were the ones who came up with the ideas.”

If a process slips, they will say, “Wait a minute. That’s not part of our Lean process.”

When performance drops off, the staff who were on the RPI teams “will sit back down and look at what’s going on. They’re the ones who own it and drive it,” Murphy says.

Success can be infectious.

“This project was so much fun,” Lingenfelter says. “You feel like you’ve made a difference. You see a difference not only in the bottom line but in the culture.”
—Pat Patterson

©OR Manager, Inc. 2009. All rights reserved. 800/442-9918. www.ormanager.com

About the Enterprise Innovation Institute:
The Georgia Tech Enterprise Innovation Institute helps companies, entrepreneurs, economic developers and communities improve their competitiveness through the application of science, technology and innovation. It is one of the most comprehensive university-based programs of business and industry assistance, technology commercialization and economic development in the nation.

Research News & Publications Office
Enterprise Innovation Institute
Georgia Institute of Technology
75 Fifth Street, N.W., Suite 314
Atlanta, Georgia 30308 USA

Media Relations Contact: John Toon (404-894-6986); E-mail (ude.hcetag.etavonninull@noot.nhoj).