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Lean roadmap part 3+ case studies


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While many hospitals today are making an effort to introduce Lean thinking and methods into their organizations, the most important part of Lean is often overlooked: building a culture of continuous …

While many hospitals today are making an effort to introduce Lean thinking and methods into their organizations, the most important part of Lean is often overlooked: building a culture of continuous improvement. Without this it will be difficult to sustain improvements that are made, and it will be difficult to improve quickly enough to keep up with the challenges that healthcare now faces. Creating a hospital with Kaizen Spirit is not something that is easy, or that happens overnight, but it is achievable through persistence and by following a proven path or roadmap.

In the final of a 3-part series, Gerard Leone, co-author of "Roadmap for the Lean Hospital" will address the implementation and sustainment of improvement suggestions. Also, he will share 2-3 real-life case histories of Lean initiatives in the hospital setting and the results that each yielded.

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  • Lean Hospital Roadmap 101
  • Lean Hospital Roadmap 101
  • November 2009 Do not copy without permission 7S for Hospitals
  • November 2009 Do not copy without permission 7S for Hospitals
  • Transcript

    • 1. Implementing a Kaizen Suggestion System and Kaizen Case Histories
    • 2. • Principal, Leonardo Group Americas LLC. • Co-Author of Fundamentals of Flow Manufacturing, Aerospace Flow, In the OR series of Lean HospitalGerard books. • Vice President of Technology, JCIT.Leone • Trained over 5000 manufacturing professionals seeking improved performance over his tenure at JCIT and CSU. • Adjunct Instructor of Manufacturing Management at Colorado State University. • Implementation Leader in over 150 businesses of various sizes. • Lean Hospital work since 2002. • In charge of the Lean Healthcare practice at LGA. • Bilingual Spanish-English. • 12 years of manufacturing management and teaching at university level prior to consulting career.
    • 3. • Principal, Leonardo Group Americas LLC. • Co-Author of Fundamentals of Flow Manufacturing,Richard Aerospace Flow, In the OR series of Lean Hospital books. Rahn • VP of Technology, John Costanza Institute of Technology. • MBA, University of Colorado and APICS CPIM certified. • Trained over 5,000 Lean professionals since 1994. • Lean Hospital work since 2002. • Creator of the Lean Operations track for the Aerospace Supplier Excellence Alliance (SEA). • 16 years of manufacturing management at Storage Technology Corporation and Ball Corporation prior to consulting career. • Bilingual Spanish-English.
    • 4. Webinar OverviewAn important element in the creation of a culture of continuous improvement is the engagement of the entire hospital staff in sharing and implementing improvement suggestions. These ideas should be easy to think up, easy to approve, and easy to do. The approach is called “Quick and Easy Kaizen”.
    • 5. Lean Hospital Implementation Roadmap Train Leadership Team in the principles of To support the Hospital’s Lean A Lean Hospital embraces a An initial assessment of current hospital Hoshin Kanri (Goal Deployment) and formalize journey, Leaders must participative model of Continuous operations, including future vision and level internal process. Use A3-X chart and Team understand the tools and Improvement. All Lean Hospital of process improvement maturity. Includes Charter forms for all Master Plans. culture of Continuous Process employees must be trained to be a analysis of potential benefits. Improvement. part of this culture. Conduct Value Stream analysis for each unit and department to identify 1 3 TRAIN 6 opportunities for improvement. Create a START LEAN HOSPITAL ASSESS O.R. TRAIN TRAIN unit-level Master Plan. START LEAN HOSPITAL ASSESS O.R. LEADERSHIP TRAIN TRANSFORMATION OPERATIONS LEADERSHIP HOSPITAL STAFF TRANSFORMATION OPERATIONS TEAM HOSPITAL STAFF TEAM The Lean Hospital Master Plan includes a definition of identified 2 VALUE STREAM 4 7 8 Formalize the SET UP IMPLEMENT improvements, resources VALUE STREAM SET UP IMPLEMENT DEVELOP UNIT process of soliciting, ANALYSIS AND PERFORMANCE GOAL DEPLOYMENT DEVELOP UNIT required, implementation ANALYSIS AND PERFORMANCE GOAL DEPLOYMENT MASTER PLANS receiving, MASTER PLAN DASHBOARD TOOLS MASTER PLANS timeline, estimated benefits, and MASTER PLAN DASHBOARD TOOLS evaluating, andROI for the selected value streams. implementing process Establish lean performance metrics improvement and method for reporting, analysis, suggestions for the 5 and follow-up. CONDUCT entire hospital. CONDUCT PILOT PROJECTS PILOT PROJECTS Select highly visible areas for proof 9 10 SUSTAINED of concept and buy-in. Follow CONDUCT INITIAL IMPLEMENT KAIZEN SUSTAINED Roll-out unit and department CONDUCT INITIAL IMPLEMENT KAIZEN PERFORMANCE Kaizen methodology to achieve KAIZEN EVENTS SUGGESTION SYSTEM PERFORMANCE process improvement KAIZEN EVENTS SUGGESTION SYSTEM results in less than 5 days. activities per the Lean Certify all Internal Lean Hospital Master Plan. Mentors through completion of actual projects and 15 14 IMPLEMENT Knowledge Checks. ROADMAP IMPLEMENT ROADMAP SUSTAINABILITY COMPLIANCE AUDIT SUSTAINABILITY COMPLIANCE AUDIT ROADMAP ROADMAP 13 12 KAIZEN MENTOR 11 KAIZEN MENTOR KAIZEN MENTOR INSTITUTE KAIZEN MENTOR CERTIFICATION INSTITUTE CERTIFICATION CERTIFICATION UNIT CPI TEAM Conduct a comprehensive, lean- CERTIFICATION TRAINING UNIT CPI TEAM TRAINING focused audit, with the objective of advancing the Lean Culture at the Hospital. Each team leader presents the status of Organize a local Continuous completed Kaizen projects to ensure Train a team of Hospital Staff Process Improvement Team to results and sustained performance. to become internal Lean identify, evaluate, and Mentors. implement improvements.
    • 6. Kaizen Suggestion System Roadmap SYSTEM LEAN HOSPITAL KAIZEN SUGGESTION Quick and Easy (Q&E) Kaizen Continuous Process Improvementis the soliciting, documenting, (CPI) meetings are led by a reviewing, approving and department manager, and take Prioritize ideas according to your implementing small place at least weekly. Suggestions 4 CONDUCT STAFF CPI hospital’s unit priorities or KPIs. improvement suggestions by are captured during this meeting. CONDUCT STAFF CPI hospital staff. Initial training MEETINGS For non-Q&E suggestions, identify MEETINGS will be needed. the financial benefits and Use KMS to document detailed qualitative benefits. These tasks, key participants, value 1 CONDUCT CONDUCT suggestions will require planning. streams affected and expected Q&E KAIZEN Q&E KAIZEN 5 benefits. Use A3 Team Charter TRAINING TRAINING 6 format for a consistent format. 5 REVIEW AND Establish activity date. ENTER SUGGESTIONS REVIEW AND ENTER SUGGESTIONS APPROVE KAIZEN FOR IMPROVEMENT APPROVE KAIZEN FOR IMPROVEMENT PROJECTS 2 CONDUCT PROJECTS START KAIZEN 2 CONDUCT START KAIZEN MANAGEMENT SUGGESTION SYSTEM MANAGEMENT SUGGESTION SYSTEM KAIZEN TRAINING Capture suggestions during KAIZEN TRAINING the Kaizen meetings and enter 7 8 9 into KMS. Suggestions will PROCESS Q&E PRIORITIZE COMPLETE KAIZEN PROCESS Q&E PRIORITIZE COMPLETE KAIZEN also come from Value Stream SUGGESTIONS SUGGESTIONS PLANNING SUGGESTIONS SUGGESTIONS PLANNING 3 SET UP KAIZEN Mapping and independent SET UP KAIZEN MANAGEMENT input. MANAGEMENT DATABASE Good preparation is a key to success, DATABASE Review, approve and An electronic database is including coordinating with all staff implement ideas at the unit needed, with ability to members, gathering required data or department level. In most 10 manage and share data and securing resources. COMPLETE KAIZEN cases the submitter is also COMPLETE KAIZEN across the hospital system the implementer. Provide EVENT PREPARATION EVENT PREPARATION and submit ideas easily. feedback within 24 hours. Conduct the event according to the Kaizen Event Roadmap. The A3 Project Status The Kaizen Leader will 1 Report documents the Pre 1 Keep hospital informed on the latest prepare the final Kaizen CONDUCT KAIZEN CONDUCT KAIZEN suggestions approved and projects and Post-Kaizen state with Event summary in A3 EVENT EVENT available. Update dashboard and status an explanation of the tools Project Status format. report. Show results to all employees. applied and the benefits achieved. 1 13 1 4 FUNCTIONAL KAIZEN COMMUNICATE POST RESULTS OF A3 2 COMPLETE A3 FUNCTIONAL KAIZEN COMMUNICATE POST RESULTS OF A3 COMPLETE A3 SUGGESTION SYSTEM RESULTS TO HOSPITAL PROJECT STATUS PROJECT STATUS SUGGESTION SYSTEM RESULTS TO HOSPITAL PROJECT STATUS PROJECT STATUS
    • 7. Webinar TopicsKaizen Roadmap The Potential Is Huge The Roadmap: Record, Review, Execute, Follow-up Case Histories:  ED to Admit Process  Hospital Supervisors  OR Supplies Management Next Steps
    • 8. Phase 5: Recording Suggestions
    • 9. Phase 6: The Review ProcessThe Goal Is To Say Yes Levels of Review  Review and Approval is Necessary.  Unintended Consequences.  Department Manager, then Lean Steering Committee.  Response Time: 24 hours for Q&E improvements.  Post improvements visually.
    • 10. Phase 7: Q&E ImprovementsLess Effort Needed Levels of Review Approval by Department Manager. 90%+ of the improvements should be Q&E. Don’t require ROI analysis. Person suggesting the improvement will do it. Avoid holding up big projects as examples.
    • 11. Phase 8: Prioritizing Kaizen Events Simple Prioritization Problems Are Jewels Y-Axis: Level of Difficulty and Cost (1-10) X-Axis: Level of Benefit (1-10) Once a decision to go ahead is made, put the Kaizen Event on a calendar. Another method: Hoshin Kanri A3-X Chart. Another method: ROI comparison.
    • 12. Phase 9: Complete Kaizen Planning
    • 13. Phase 10: Kaizen Preparation
    • 14. Phase 12/13: The A3 Project Status
    • 15. Phase 14: Communication Vehicles
    • 16. Case History 1ED to AdmitPatient Flow
    • 17. ED-to-Admit TimeOpportunity for Improvement Benefits AchievedSeveral months worth of data show thatthe time to obtain a bed for an admittedpatient through the ED was an average of62 minutes. Furthermore, once the bedwas assigned, the time to get the patientto the bed in the admitting unit was 81min on the average. The total average waittime a for an admitted patient was 143minutes. This was a great source offrustration for the ED and admitting unitRNs as well as a low point in patientsatisfaction surveys.
    • 18. Case History 2 HospitalSupervisors
    • 19. Hospital SupervisorsOpportunity for Improvement Benefits AchievedDuring a Value Stream Mapping exerciseaimed at improving patient flow, it wasidentified that the whole control over bedplacement was in the hands of theHospital Supervisor. The HospitalSupervisor position at EGSMC wasoriginally devised as the “Air TrafficController”. Hospital Supervisorscommented on the fact that their main jobof bed placement was severely hinderedby having to deal with many spurious callsthat distracted them from placingadmitted patients in beds.
    • 20. Case History 3OR MaterialsManagement
    • 21. OR Materials ManagementOpportunity for Improvement Benefits AchievedThe unpredictable availability of surgicalsupplies was identified a major source ofdissatisfaction among OR personnel andsurgeons. Furthermore, the hospital’ssenior leadership team indicated that theamount of inventory dollars in thePerioperative Services department was farhigher than in most of the benchmarkedhospitals..
    • 22. Next StepsGenerally Speaking Kaizen OnDemand• Embarking on a Kaizen • One way or another, you will initiative is no small need a KMS. undertaking. • Home-grown solutions may• Make sure you have a solid seem attractive, but will cost infrastructure of you much more. commitment, KMS, training, • Leverage the input from a Lean Management System community of users. before starting. • Request a 1:1 demo or view• The potential is huge, so get our April 17th KMS demo up the learning curve fast. (see post-webinar survey)
    • 23. Questions?Leonardo GroupPrincipals: Gerard Leone & Richard D Rahn303-494-4404Boulder, Co 80303 PowerHealth OnDemand Keith Snyder l Director of Marketing 720-290-6513 Greenwood Village, Co 80111