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Eliminate Waste:
Remove Intermediaries

Intermediaries such as distributors, handlers, agents, and carriers may be a standard part of a system. Consider eliminating these intermediaries by linking production directly with the consumer. Some intermediaries add value to a process because of their specialized skills and knowledge. But many times, eliminating these services can increase productivity without reducing value to the customer.




Examples of Tests of this Change

One hospital identified 31 steps involved in completing a patient transfer from the emergency department to the inpatient unit. After identifying these steps, the team removed intermediaries by asking the emergency department clerks to call the admitting unit directly, bypassing their own admitting staff, which eliminated two of the 31 steps. The team also asked the hospitalist to perform several tasks previously done by others (e.g., phoning a preliminary patient report to the inpatient unit), eliminating six more steps.


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