lean tools + design = 3P (production, preparation, process)

1. Applying Lean Principles
to the Design of
Healthcare Facilities
Sahil Sakpal, Bahaa Takieddine, Harsh Ganeriwala,
Mikey Guidosh

2. Introduction
● Design of healthcare facilities is a multivariate problem
● Important - Efficiency and Outcome
● Simultaneous technical and social issues
● Exploring Lean and 3P in healthcare facilities
● Multiple stakeholders (Examples)

3. Storyline
● National Health Service (NHS) England is responsible for
construction & refurbishment of new & existing buildings
● Target of £ 20Bn in efficiency savings
● Annual estate running cost is £7 Bn. (Need identified to reduce)
● Capital budget is £ 4Bn for building improvements
● Facility Design will have large impact on outcomes & saving
● A study conducted in 36 US hospitals found that nurses spent
19.3% of their time on patient care, and walk approximately 3
miles in day shift

4. ‘Lean’ in Healthcare
● Principles of Lean
● In healthcare, Lean leads to productivity gains
● Seeks to remove non-value adding steps
● Not all principles of Lean can be applied effectively
● Faces resistance to standardization

5. ‘Waste’ in Healthcare

6. 3P is a part of an overall Lean Design Approach that
involves Rapid Idea Testing & Embedding Lean Principles
into process and workspace design
● Spaghetti Diagram
● 10 Principles
● Virginia Mason Hospital
3P Production, Preparation, Process

7. Case Study Evaluation for 3P application
● This case focused on the endoscopy department at the
Queen Elizabeth Hospital, which was the site where 3P
approach was developed, tested and evaluated
● The design of endoscopy facilities requires a wide range
of factors to be taken into account

8. Endoscopy
● New unit being designed
● Seek 60 patients/day and 60% require
recovery
● Expected annual 10% increase in
stakeholders● To increase capacity and quality of
treatment
● Reduce lead waiting time
● Optimizing the flow of different elements

9. 3P In Endoscopy & Design Process
● Pre Workshop data Collection and Analysis
● Value Stream Mapping
● Photographic Library
● Outlining flows on Engineering Drawing
(Spaghetti Diagram)

10. Workshop
There were 26 participants:
● 2 Architects
● 1 Consultant
● 1 Junior Doctor
● 2 Patient Representative
● 1 JAG Consultant
● 1 Nurse Endoscopist
● Nurses
● Nurse Assistants
● Quality Improvement
Professionals
● Administrative Staff,
with an Appointment
Scheduler
So who ATTENDED?

11. What was done:
3P Method:
Spaghetti Diagram
Seven Flows:
● Patient
● Staff
● Medicine
● Supplies
● Information
● Equipment
● Family

12. What was done:
Lean Design Considerations
● 2D and 3D

13. Outcome
Emergent Designs Selection - Voting system using Weighted
Factor Approach
Evaluating the
benefits of Lean
Design 3P in that
hospital. NHS
adopted it as
standard in its
new healthcare
facility layout

14. What we learned about 3P benefits?
● Cross Functional Team
● Rapid Testing of Ideas
● Embedding of Lean Principles into Process Design

15. When to Use 3P? (Learned)
Changes in
Demand
Building
New Clinic
or Facility
New or
Improved
Products &
Processes
Upgrading
or
Changing
Equipment
Production
Preparation
Process

16. Thank You
for
Listening