Project: Any process that drives patient movement through the surgery department. Purpose: To improve the flow of value for the patients of the Paul Oliver Memorial Hospital Surgery/Procedure Department Targets: Fewer Cancellations, Fewer negative comments about procedure prep, fewer incomplete charts, better alignment of skills to tasks.
The processes that drive patient movement through the February 16, 2012 surgery department Initiation Date:Project: Donna Clarke – Director of Out Patient Services Debbie Link – Chief Nursing OfficerSponsor/ Leadership Panel: Peter Marinoff - COO Angie Anderson, RNValue Stream Manager (Person most directlyresponsible for the project area): Carolyn Erickson (CS), Jamie Gillison (PAS), Karen Mabrey (C. Sched.), Carolyn Feltes, RN (Pool),Team Members: To improve the flow of value for the Paul Oliver Memorial Hospital Surgery/Procedure Department.Purpose of Project: * Fewer Cancellations * Fewer negative comments surrounding the Prep processMetrics and Targets (What metrics do you * Less incomplete chartsanticipate changing after the project, what * Better aligned skills with processesare your goal numbers?): Scheduling of procedure through receipt of patient satisfaction survey.Project Scope (Beginning and end points ofthe project):Parameters (Processes that must be followed,constraints, etc.): Current Value Stream Map Future Value Stream Map Demonstrable knowledge of LEAN processes & ToolsDeliverables (Tangible outputs of the project): Complete current VSM within wk by dateTimeline, including target completion date: Sponsors will be updated weekly through August, 2012 and then monthly through December 2012.Updates (How often will leadership beupdated?):
We discussed the rules, the types of waste, and our metrics… we were ready to go!
After we finished the class-room work of defining each step of the Colonoscopy process, it was time to go to where the work is done (The GEMBA) and see how it all fits together. This is also where we collect our data!Central Scheduling OR Office Central Supply
There was major disconnect in theOrdering of Stock Room Supplies for theLTC › Staff were requesting supplies to be ordered that were already on order causing a lot of over-ordering › The stock was running out on the floor causing low par levels › Things were being stored in multiple places throughout the store room and on the floor.
We Sort, Set in order, Shined, Standardize and Sustained… › This included cleaning the supply room and removing items that didn’t belong › We organized things that were “like” in order to make finding items easier › We cleaned the floor and ordered new storage items › We labeled everything!!! We used item names and numbers, par levels and corresponding order forms.
Now staff can easily identify what products go where, what should be orderedwhen it’s gone and how much of each supply we stock!
We also needed a way to let all shifts know when items were ordered and when they would arrive…
We focused on two areas that had relatively low % complete & accurate › Information complete and correct from registration There were 4 hand-offs of patient material in the current value stream. We reduced this to just 2 hand-offs with a minor change. › PAS being able to contact the RN when patient arrives. The current state had the patient checking in at the front desk, waiting in the lobby, being taken by a RN to another waiting area, and then back to the Recovery Room.
PAS Schedules - Prints PAS stickers Chart and Itinerary x 2 files. Or Picks up 1 copy of RN Picks up Chart on day Itinerary & Makes Chart of surgery BEFORE AFTER RN Picks up packet and creates/stickers chart & returns to front deskPAS Schedules, PrintsItinerary (x1), stickers and Patient brings chart to ORfacesheets waiting area for RN
Next we met as a group to discuss what we want the future of thisValue Stream to look likeTHINGS WE NOTED1) Many small changes had already improved some of the steps, and added value to most of them.2) We had to really focus on thinking about what we WANTED the future to look like and look beyond the obstacles that were present NOW