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Managing Lean Hospitals

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ws chaired by james p womack - lei – glhs – 25.06.07shown at the 1st Global Healthcare Summit on 25th June 2007

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  • DOWNLOAD FULL BOOKS, INTO AVAILABLE FORMAT ......................................................................................................................... ......................................................................................................................... ,DOWNLOAD FULL. PDF EBOOK here { https://tinyurl.com/yyxo9sk7 } ......................................................................................................................... ,DOWNLOAD FULL. EPUB Ebook here { https://tinyurl.com/yyxo9sk7 } ......................................................................................................................... ,DOWNLOAD FULL. doc Ebook here { https://tinyurl.com/yyxo9sk7 } ......................................................................................................................... ,DOWNLOAD FULL. PDF EBOOK here { https://tinyurl.com/yyxo9sk7 } ......................................................................................................................... ,DOWNLOAD FULL. EPUB Ebook here { https://tinyurl.com/yyxo9sk7 } ......................................................................................................................... ,DOWNLOAD FULL. doc Ebook here { https://tinyurl.com/yyxo9sk7 } ......................................................................................................................... ......................................................................................................................... ......................................................................................................................... .............. Browse by Genre Available eBooks ......................................................................................................................... Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult,
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Managing Lean Hospitals

  1. 1. First Global Lean Healthcare Summit 25-26 June 2007 Managing a Lean Hospital: Only a part of the Patient Journey!!! Martin Turner, Chief Executive, Gwent Healthcare NHS Trust
  2. 2. First Global Lean Healthcare Summit 25-26 June 2007 Our Customers: 600,000 Resident Population Caerphilly 177,000 29.5% Blaenau Gwent 76,400 12.7% Torfaen 93,600 15.6% Newport 140,400 23.4% Monmouthshire 89,200 14.9% Others 23,400 3.9%
  3. 3. First Global Lean Healthcare Summit 25-26 June 2007 We are a Large Healthcare Provider • 3 hospitals providing acute services • comprehensive mental health services • 15 other hospitals 41 health centres and clinics Over 13,000 staff 6,000 nurses 1750 allied health workers Over 1000 doctors Including 260 Consultants
  4. 4. First Global Lean Healthcare Summit 25-26 June 2007 Emergency admissions Non-emergency admissions Day cases New outpatients Follow-up outpatients Obstetric admissions Accident & Emergency 68,300 15,017 49,350 115,000 277,113 9,200 158,670 692,650 187 41 134 316 759 25 434 1,896 Average weekday Demand for Services
  5. 5. First Global Lean Healthcare Summit 25-26 June 2007 Our Challenges • Service provision model unsustainable – Unsafe (21st Century) – 75% of our estate is > 60 years old – Not EWTD compliant – In the wrong place • We believed we were inefficient • Senior Doctors did not. • Not enough money (£35MM revenue) • Government Targets – Waiting Lists – efficiency
  6. 6. First Global Lean Healthcare Summit 25-26 June 2007 So What? • Clinical Futures Program • Efficiency Plan (£35- 50MM revenue) • Organisational Development – Lean – Clinical Leadership
  7. 7. First Global Lean Healthcare Summit 25-26 June 2007 Our Lean Journey • Started 2003 – Used an Event approach (86) • Executive Review of Progress 2005 – Why is performance what it is? • Deep Cause Analysis – Mental models of staff : Why we do things this way…. • Blind spot to standardisation • Informal approaches • Part time resources • Changes in Priority • Lack of Operational management • New/Current Approach – Select an Exemplar – Strategic/Process/Operational focus
  8. 8. First Global Lean Healthcare Summit 25-26 June 2007 What is an Exemplar – By exemplar we mean a Future state where best practise experiments are conducted and standardised without the influences of the Deep causes of the current organisational approaches. – A laboratory where we carry out experiments in process and organisation re-design. These can then be deployed into the rest of the organisation in a controlled manner. – End 2 End Lean Patient Value Streams
  9. 9. First Global Lean Healthcare Summit 25-26 June 2007 Focus on the End to End Exemplar: Our Laboratory • 1 hospital providing acute services • 4 other hospitals 13 health centres and clinics • Serving 180,000 local residents (30% of Demand)
  10. 10. Clinical Consummables Goods Annual Cost 0 50000 100000 150000 200000 Before After £s 30% reduction CT Scan Lead Time Improvement 0 1 2 3 4 5 6 7 Before After Delay for off site scan Days Patient 'Right First Time on Time' Diagnostics & Treatment 0 20 40 60 80 100 120 Apr-07 May-07 Jun-07 % JI Programme No. of Staff Trained 0 20 40 60 80 100 Apr-07 May-07 Jun-07 Productivity Improvement General Medicine CDMH 0 20 40 60 80 100 May 06 - Sep 06 Oct 06 - Mar 07 Apr 07 on Beds patients per bed per week 300% improvement Up 24.5% Up 19% Up 47% >90% trained on time
  11. 11. First Global Lean Healthcare Summit 25-26 June 2007 Lessons Learned • Not as complicated as we are told. • People get motivated by this approach – Bloody obvious when they don’t………. – But you have to deal with them (says more about you) • Not for free…. – Speed is limited by the number of skilled people you have working towards the Future State • Patient Journey 11,000 minutes, 94 minutes hands on – You must keep coming back to this.. • We believe it is Win/win/win for Patient/Clinician/Manager – But nobody believes it to begin with. • Created a ‘Pull’ within the organisation
  12. 12. First Global Lean Healthcare Summit 25-26 June 2007 So where next for us? • Next 12 Months: • Develop the Model: – Roll out through ‘Learn by doing’ – Increased Capacity (Additional 30 People) – Develop & Deploy Organisational strategy & plans • 2 to 5 Years: – Lean Clinical Futures Model

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