In this workshop, we broadcast live from the 25th Annual IHI Conference in Florida.
Dr. John Boulton, IHI Fellow and Rheumatologist, joins the panel to give his insight on using Lean and Simulation methodologies to improve healthcare processes and delivery.
The team will discuss recent research on the topic, the benefits of using Simulation in Lean projects, and will also present feedback from delegates at IHI and your chance to put your questions to the panel.
5. Messages from Research
“Simulation and lean are approaches that
are rarely discussed together, particularly in
the healthcare context. This is surprising
given that they have a similar motivation:
improvement of processes and service
delivery”
Warwick University – Simlean/SLIM simlean.org
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6. What does Simulation add to Lean?
Reflections from SimLean research
participants:
• Dynamic process maps
• What if? scenario tool
• Accelerates understanding
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7. Testing, testing…Live from IHI
Agenda
•
•
•
•
Simulations of Lean concepts
IHI participants’ feedback
Implications for Simulation
Reflections from Dr. John Boulton
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8. Lean and Simulation Communities
Why don’t they work together more?
Both improvement methodologies are
powerful change agents – surely we need all
the help we can get to improve healthcare?
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9. Our Hypothesis
• Experts in both domains are passionate
about their own methodology and don’t
look to combine approaches
• We believe that if Simulation is used to
explain Lean concepts, we can bridge this
gap.
• The LeanSIM Toolkit:
– Demonstrates Lean principles
– Allows users to experiment with parameters
and quickly see results
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12. LeanSim – Batching vs.
Single Piece Flow
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13. What does the IHI community think?
•
“As a teacher of Lean, I often find it difficult to get buy-in
on Lean concepts since they are counter-intuitive until
Pictures actually live them.stand and quotations
of people at This brings them to life.”
you
“I’ve often struggled to use simulations to explain Lean
concepts as they are all manufacturing examples.
Having healthcare SIMUL8.com | info@SIMUL8.com
SIMUL8 Corporation | scenarios is so powerful!”
14. Click to edit Master title style
“Why isn’t
every
hospital
using this?”
- Sara Dalo
SIMUL8 Corporation | SIMUL8.com | info@SIMUL8.com
15. What we heard at IHI...
• Lean simulations are a really powerful
communication tool.
• Passion of clinicians to continually improve
is alive and well.
• People are busy with day-to-day tasks and
struggle to find time to use the techniques.
• Evidence-based solutions are still needed to
complement cultural change management.
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16. Implications for Lean and Simulation
1. Simulation is a powerful means of engaging
stakeholders and enabling collaboration in
change programs.
2. Educational models are needed to bring Lean
concepts to life.
3. Simulation will help with the IHI challenge for
new patient-centered service models by
demonstrating the impact on resources,
outcomes and costs.
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17. Simulation and Lean –
Improving Process Improvement
Simulation is a powerful tool, which is even most effective when integrated with the Lean
Six Sigma approach. By doing so, we can maximize the impact of our improvement efforts.
Understand
dependencies.
Value Stream
Mapping
• Conduct
observations.
• Collect data.
• Document
value stream
statistics.
Identify
Improvement
Opportunities
• Document all
barriers,
rework, and
wait times.
Incorporate
variability
into VSM.
Validate your
current state.
Prioritize
Projects
Develop
Charters
• Estimate the
impact and
effort for each
improvement.
• Combine for
prioritization.
• Define
process and
outcome
metrics.
• Establish
target (%) for
improvement.
Reduce risk.
Map Current
State
Design Future
State
Pilot
Future State
• Create a
detailed
process map.
• Identify
potential
interventions.
• Develop and
document a
future state
process map.
• Implement
the proposed
future state
on a small
scale.
• Identify issues
& unexpected
effects.
Set evidencebased targets.
Visualize
improvement
results.
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Implement
Sustain
• Modify the
future state as
needed.
• Conduct
training.
• Go live.
• Document
standard work
and policies &
procedures.
• Monitor and
sustain
improvements
.
Gain buy-in.
18. About me
• Rheumatologist
• Clinical lead for Quality Improvement
• 2012-13 IHI QI Fellow
– High reliability principles
– System wide flow
• An interest in simulation and modelling
• Twitter: @the_Rheum_doc
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19. What does the IHI community think?
•
“As a teacher of Lean, I often find it difficult to get buy-in
on Lean concepts since they are counter-intuitive until
Pictures actually live them.stand and quotations
of people at This brings them to life.”
you
“I’ve often struggled to use simulations to explain Lean
concepts as they are all manufacturing examples.
Having healthcare SIMUL8.com | info@SIMUL8.com
SIMUL8 Corporation | scenarios is so powerful!”
20. Click to edit Master title style
“Why isn’t
every
hospital
using this?”
- Sara Dalo
SIMUL8 Corporation | SIMUL8.com | info@SIMUL8.com
26. “If I had to reduce my
message for
management to just a
few words, I’d say it
all had to do with
reducing variation.”
W. Edwards Deming
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32. SIMUL8 Corporation | SIMUL8.com | info@SIMUL8.com
Associates
in Process Improvement
33. Simulation and Quality Improvement
• A useful tool
– Enables deeper understanding of systems
– Translates difficult and counterintuitive
concepts
– Virtual PDSA cycles
• Models do not need to be complex
– Simple are often more effective
SIMUL8 Corporation | SIMUL8.com | info@SIMUL8.com
34. LeanSim Toolkit
We’d love you to try these models
yourselves and give us your feedback.
To download your own copy link to:
SIMUL8healthcare.com/LeanSIMToolkit
SIMUL8 Corporation | SIMUL8.com | info@SIMUL8.com