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Production, Preparation, Process (3P) Design Drives Better, Faster, More Affordable Care

SEATTLE - (October 19, 2011) — The first thing that strikes you when you walk into Virginia Mason Medical Center's new emergency department (ED) is the size of the waiting room, or rather it's lack of size. At a time when the average wait in U.S. urban emergency rooms has soared above six hours, the waiting room in the new ED of the hospital's now-open Jones Pavilion is no bigger, and probably smaller, than most strip-mall coffee shops.

According to Karen Gifford, RPh, administrative director of hospital operations, there isn't going to be very much waiting — if any at all. Thanks to more than a decade of leveraging the Virginia Mason Production System (VMPS) to improve processes, eliminate waste, lower costs and improve outcomes, Gifford says patients needing emergency care will see a doctor faster than ever before.

"People typically come to the emergency room because they are acutely ill. Making them wait is disrespectful, and study after study shows it just makes their condition worse," said Gifford. 

The first step, Gifford said, was to use a tool called "3P" (Production, Preparation, Process) to bring together builders, architects, doctors, nurses, paramedics and patients to design the ideal facility to support the most efficient and highest quality emergency care. "Then using other VMPS tools, we continued to refine and improve both the design and our care processes to ensure that our patients move from arrival at the ED to assessment, treatment and discharge or admission to the hospital in the most efficient way possible with the highest quality outcome," said Gifford. "That's why we don't need a big waiting room."

Nearly 23,000 people arrive at Virginia Mason's ED for treatment each year. Virginia Mason Chairman and CEO Gary S. Kaplan, MD, said that without VMPS and 3P design, treating that many patients would have required a much larger, more expensive, ED with more treatment rooms.

"Hospitals all over the country are spending millions of dollars to build huge emergency departments to cope with the rising demand for care, instead of putting resources into figuring out how to deliver the care that people need more efficiently," said Dr. Kaplan. "I genuinely believe this ED will be a model for the entire nation. Our design efforts focused first on engaging our staff and the community to generate ideas on how to improve the care processes and only then turned to designing the physical space to support delivering that care as quickly and efficiently as possible."

A grand opening ceremony for the Jones Pavilion will be held Saturday, Oct. 22, at 11 a.m. near the intersection of Spring Street and Boren Avenue, just outside the entrance to the new ED. An open house for the new ED will follow.

Virginia Mason's new emergency department is just the latest and the most visible service to be located in the new Floyd & Delores Jones Pavilion, named after long time supporters and benefactors of Virginia Mason. Inpatient Orthopedics moved into Level 11 of the Jones Pavilion in July, with new operating and procedure rooms, a new intensive care unit, medical surgical units, and other services still to come — all designed with the same 3P process as the ED. As these services transition to the Jones Pavilion, 3P processes will also be used to drive renovation of space in Virginia Mason's existing Central Pavilion.

Just as the new ED was built to support efficient care, so, too, are all patient care areas of the new Jones Pavilion. Every floor features treatment rooms designed with the flexibility to care for any type of patient, which reduces admission times, wait times, patient transport and other delays in care. Combined with the care delivery improvements achieved by using VMPS, these designs are reducing patient lengths-of-stay by more than 20 percent, leading to higher quality, safer care, greater patient satisfaction and less-costly care. More patients can be treated because of better and more efficient use of resources.

The rooms themselves include enhanced efficiency, safety, and patient and family amenities, including patient lifts, barrier-free bathrooms, family sleeping couches, extra-wide doors and room servers that allow supplies to be restocked from outside the room without disturbing patients. Other innovations include infection control and isolation rooms on each floor, window designs to ensure patient privacy and state-of-art seismic protection.

You may take an interactive tour of the Jones Pavilion at

The new ED features 17 treatment rooms, including a procedure room, a decontamination area, a satellite lab to quickly run the most common tests, a direct pneumatic tube connection to the main laboratory, and its own radiology and CT scanner suite.

A key to the efficiency of the new ED is what Virginia Mason calls the PACE unit — which stands for Patient Accelerated Care Environment. In most EDs, patients who are not acutely ill, but cannot be immediately discharged or admitted, are cared for in the ED as "observation" patients.

At Virginia Mason, those patients will be moved to the adjacent PACE unit (Central Pavilion, Level 7), where they will receive individualized care to efficiently move them toward either discharge or inpatient admission. This not only provides better patient care, it removes the bottleneck and makes ED resources available for more acutely ill patients who might otherwise be forced to wait.

The first patients will be seen in the new ED beginning Nov. 2.

Media coverage of the new ED and the grand opening ceremonies on Oct. 22 is welcome. Please contact John Gillespie, Media Relations Manager, for assistance in arranging coverage.

About Virginia Mason Medical Center
Virginia Mason Medical Center, founded in 1920, is a nonprofit comprehensive regional health care system in Seattle that combines a primary and specialty care group practice of more than 440 physicians with a 336-bed acute-care hospital. Virginia Mason operates a network of clinics throughout the Puget Sound area, and Bailey-Boushay House, a skilled-nursing facility and chronic care management program for people with HIV/AIDS. The medical center is affiliated with Benaroya Research Institute at Virginia Mason, internationally recognized in autoimmune disease research. Virginia Mason is known for applying manufacturing principles to health care to improve quality and patient safety. For more information, visit or or follow @VirginiaMason on Twitter.

For media inquiries, contact:
John Gillespie, Media Relations Manager
(206) 341-1509 (o)
(206) 402-2822 (m)

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