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The lean hospital what is mean

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The lean hospital what is mean

  1. 1. The Lean Hospital: ? What does it mean DR EMAD KOTB QUALITY MANEGMENT DIRECTOR RAFHA CENTRAL HOSPITAL
  2. 2. QI Process Methodologies •FOCUS-PDCA •Six Sigma “DMAIC” “3.4/million defects” •Lean QI Process “No waste”
  3. 3. The FOCUS -PDCA Methodology IND AN OPPORTUNITY ORGANIZE A TEAM CLARIFY THE PROCESS UNDERSTAND THE PROBLEM(S) SELECT A DESIRED OUTCOME
  4. 4. ?What does Six Sigma mean The term “Sigma” is a measurement of how  far a given process deviates from perfection – a measure of the number of “defects”. Six Sigma correlates to just 3.4 defects per .million opportunities A quality improvement methodology that • applies statistics to measure and reduce .variation in processes A management system that is • comprehensive and flexible for achieving, .sustaining, and maximizing success 2 308,537 3 66,807 4 5 6 6,210 233 3.4
  5. 5. Measurement: Six Sigma as a Quality Goal The higher the sigma, the 3 fewer the defects. A increase from 3 to 6 Sigma represents a 20,000 fold improvement in quality. σ Defects Per Million Opportunities 1 2 3 4 5 6 697,672.15 308,770.21 66,810.63 6,209.70 232.67 3.40 99% “Good” (3.8 Sigma) 99.99966% “Good” (6 Sigma) No electricity for 7 hours per month No electricity for 1 hour every 34 years 5,000 incorrect operations per week 1.7 incorrect operations per week 20,000 wrong prescriptions per year 68 wrong prescriptions per year The Quality Colloquium Introduction to Track IC: Six Sigma as a Healthcare Quality Initiative
  6. 6. ”Improvement Methodology: DMAIC “Backbone VE O PR IM Performance Improvement Benchmarking L RO T ON C E YZ AL AN Sustain improvement Devise solution(s) and implement …and validate root cause(s) RE U AS ME …the current process capability (get the data!) NE I EF D …the problem in a measurable way Project Timeline The Quality Colloquium Introduction to Track IC: Six Sigma as a Healthcare Quality Initiative Return on Investment (ROI) Control Tools
  7. 7. ? Happy at 99.9% …If 99.9% is acceptable to you, then• Your heart fails To beat 32,000 Times each year• surgical Operations are performed wrongly 500• Every week wrong Drug prescriptions Made every year 20,000 babies are dropped by doctors At birth 19,000
  8. 8. 2,000 unsafe airplane landings are made every day • 2 major airplane accidents per week
  9. 9. ?What is Lean Thinking A methodology to produce the • highest quality product in the shortest amount of time, at the lowest possible cost by ”.eliminating the “seven wastes Fosters a culture which encourages • all employees to continually look for improvement  
  10. 10. Waste in healthcare The national numbers for waste in“ healthcare are between 30% and 40% but the reality of what we’ve observed by minute-to-minute observation over ... the last three years is closer to 60% It’s everywhere: patient care and non”.patient care alike   
  11. 11. Toyota in Healthcare Creating an environment of stability • Elimination of waste • Rapid identification and correction • of errors   
  12. 12. Forms of Waste 8 WASTED HUMAN TALENT Human Potential Not engaging employees in problem solving  DEFECTS paperwork, med errors  INVENTORY unneeded stock or supplies  OVERPRODUCTION unnecessary tests  WAITING TIME delays in diagnosis and  treatment  MOTION movement of staff and information  TRANSPORTATION movement of patients or equipment PROCESSING WASTE filling out extra paperwork  13
  13. 13. 1. Wasted Human Talent I’ve made a few changes to the process. I wish someone would ask OUR opinion…! Staff Staff Manager Staff Staff Staff Not asking the staff that works the process how to improve it 14
  14. 14. 2. Defects Another defect!! @*&#! ! A negative outcome from process failure 15
  15. 15. 3. Inventory Did I really order this much?? Items in greater quantities than can be immediately processed or used. 16
  16. 16. 4. Over Production Hey…are these multiple orders for the same thing? @#$&*!! Pharmacist I didn’t get my order yet… I’ll send another fax. Staff Generating more work than is really required 17
  17. 17. 5. Waiting People waiting for items (patients, supplies, specimens, etc.) to process 18
  18. 18. 7. Transportation Waiting Area I’ll bring the patient right over. I have orders to run some tests. Sigh…..!! Unnecessary movement or relocation of items 19
  19. 19. 8. Over Processing Please approve. Please approve. Please approve. Please approve. Please approve. Please approve. 20
  20. 20. 8. Over Processing I’m the final approval. Please ?? The final approve. ? approval?!! + Applying effort to activities that are not required in the process 21
  21. 21. What is 6S? Sort Straighten Scrub Standardiz e Sustain 1. 2. 3. 6. Safety 4. 5. 22
  22. 22. Step 1: Sort Before After Separate the needed from the not needed 23
  23. 23. Step 2: Straighten BEFORE AFTER A place for everything & everything in its place! 24
  24. 24. (Step 3: Scrub (inspect “Scrub” and inspect equipment to ensure it is in perfect working condition... Add inspecting equipment into your work routine. Regularly “scrub” to ensure everything is in perfect working condition 25
  25. 25. Step 4: Standardize Note: Blue taped outlines and labels ensure equipment is quickly found and returned to the same spot every time. Standard Work requires determining the best method then following that method every time. 26
  26. 26. Step 5: Sustain Develop a method for sustaining your gains 27
  27. 27. ?How do I Conduct a 6S 28
  28. 28. aration Observe the process first hand  Create a diagram - a hand drawn :map of your process including Tasks in the sequence they are done • Location of supplies and equipment • Measure distance traveled and time • spent searching or waiting Good preparation is the key to successful results! 29
  29. 29. ?How Can We Improve ?What would you do to improve Sort out the need from the not needed  Have a place for everything so there is no searching  Move supplies or equipment closer to where they are needed Co-locate tasks or people   Change the sequence in which tasks are done  Be creative with your solutions – you, after !all, are the expert  Applying 6S eliminates waste! 30
  30. 30. photo Suggest you insert some before and after pictures/examples of 6S results .in the next few slides  31
  31. 31. ?How Can We Use 6S to Improve Sort – Separate the needed from the 1. Straighten – A place for everything 2. not needed and everything in its place Scrub – Ensure everything is in perfect working condition 3. Standardize – Determine the best .method – visual queues, labeling, etc Sustain – Develop Standard Work Safety – Safety first at all times 4. 5. 6. 32
  32. 32. ?What Waste Did You Observe 1. Wasted Human Talent 2. Defects 3. Inventory 4. Over Producing 5. Waiting 6. Motion 7. Transportation 8. Over Processing 33
  33. 33. Goals Patient Safety Patient Satisfaction Employee, Staff Satisfaction Employee Engagement Low Turnover Productivity Space Utilization
  34. 34. That’s just the way work is done around here Waste becomes accepted
  35. 35. Challenge We don’t see it as waste!
  36. 36. Total Lead Time Value Added 5% NonValue Added 95%
  37. 37. WE MUST THINK ABOUT LEAN
  38. 38. THANK YOU

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