1. Kaizen A3 ReportKaizen A3 Report
Hospital Administration: Lean Process and Quality
Improvement in Hospital Operations
By:
Nicholas
A.
Thompson,
MPH
(c)
Lean
process
improvement
has
become
more
pervasive
since
it
was
first
used
by
Toyota
Manufacturing.
Close
to
40
years
later,
Lean
was
widely
adopted
by
health
care
and
began
helping
ins@tu@ons
edge
closer
to
achieving
the
Triple
Aim:
enhancing
the
pa@ent
experience,
improving
clinical
outcomes,
and
reducing
costs.
One
health
system
in
par@cular,
Thomas
Jefferson
University
Hospitals
(TJUH),
has
leveraged
Lean
to
“make
Jefferson
the
best
at
geMng
beNer.”
Two
Lean
projects
at
TJUH—standardizing
new
pa@ent
intake
forms
and
improving
specimen
processing
flow—exhibit
the
applica@on
and
results
of
Lean
process
improvements.
Non-­‐value
adding
steps,
or
waste,
are
common
in
processes.
1. New
pa@ents
filled
out
duplica@ve,
long
forms
resul@ng
in
pa@ent
dissa@sfac@on.
2. Inefficient
specimen
flow
results
in
accruing
over@me
hours
increasing
the
poten@al
of
going
over
budget
By
iden@fying
wastes,
categorizing
them,
and
applying
countermeasures,
ins@tu@ons
can
improve
processes
and
workflows.
1. Goals
for
new
pa@ent
forms
included
standardizing
packets
amongst
prac@ces
to
reduce
waste
and
streamline
the
process
of
becoming
a
Jefferson
pa@ent.
2. The
goals
of
assessing
specimen
processing
flow
are
increased
efficiency
for
@mely
turnaround
of
specimens
and
fewer
over@me
hours
accrued.
Countermeasures
are
ac@onable
steps
taken
to
address
the
iden@fied
waste.
1.
Standardiza?on
in
new
pa?ent
forms
achieved
through:
• Upda@ng
packets
to
include
new
Jefferson
logo
and
what
items
a
pa@ent
should
bring
to
appointments;
paring
down
to
required
forms/
pamphlets
• Communica@ng
with
staff
to
implement
process
of
emailing
forms
2.
Streamlined
specimen
processing
flow
through:
• Reducing
wastes
in
mo@on
and
transporta@on
by
centralizing
the
processing
to
one
loca@on
• U@liza@on
of
electronic
tools
to
check
pa@ent
status
and
prevent
unnecessary
travel
and
wai@ng
• U@lizing
specimen
processing
wai@ng
@me
to
label
next
day’s
samples
Results
include
the
metrics
monitored,
data
collected,
and
desired
direc@on
of
the
metrics.
Results
should
quan@fy
reduc@ons
in
form
length,
amount
of
@me
to
fill
out
forms,
over@me
hours
accrued,
and
wai@ng/transporta@on
@me.
These
reduc@ons
translate
into
a
beNer
customer
experience,
improvements
in
quality,
and
lower
costs.
1.
Standardiza?on
of
new
pa?ent
forms
• Decreased
amount
of
@me
to
fill
out
packet
by
pa@ent:
15
min.
à
5
min.
• Reduced
@me
for
staff
to
send
email
vs.
pack
envelope
• BeNer
u@liza@on
of
staff
@me
and
exper@se
2.
Specimen
Processing
Flow
• Decreased
hours
of
over@me
accrued
by
Clinical
Research
Coordinator
II
posi@on
within
the
Clinical
Research
Management
Office
à
New
hire
trained
with
improved
process.
Next
steps
iden@fy
how,
when,
and
who
will
implement
countermeasures.
It
also
includes
a
discussion
of
the
barriers
that
may
need
to
be
addressed
to
ensure
countermeasures
can
be
successful.
The
opportuni@es
to
apply
Lean
in
the
healthcare
seMng
are
endless.
Lean
process
improvements
can
reduce
errors,
cost,
wai@ng,
and
waste
while
improving
quality,
produc@vity,
workflows,
and
customer
sa@sfac@on.
Importantly,
Lean
methodology
empowers
employees,
enables
con@nuous
improvement,
and
encourages
sharing
of
best
prac@ces
and
lessons
learned
to
advance
the
en@re
health
care
system
toward
the
Triple
Aim.
Remember:
Think
Lean,
Don’t
Do
Lean.
BACKGROUND
PROBLEM
STATEMENT
PROJECT/
PROPOSAL
OBJECTIVE
COUNTERMEASURES
RESULTS
NEXT
STEPS
• Lean
Enterprise
Ins@tute.
(2015).
What
is
Lean?
Retrieved
from
hNp://www.lean.org/
WhatsLean/
• Graban,
M.
(2011).
Lean
Hospitals:
Improving
Quality,
Pa@ent
Safety,
and
Employee
Engagement.
Boca
Raton,
FL:
CRC
Press.
REFERENCES
Thank
you
to
Dennis
Delisle,
Sc.D.,
FACHE,
and
Leigh
Resnick,
MS,
RRT,
for
their
help
and
support
with
these
and
many
more
projects.
ACKNOWLEDGEMENTS
Figure
1:
32.1%
average
reduc?on
in
non-­‐value
adding
(NVA)
waste
Figure
2:
Average
monthly
savings
on
printed
materials
is
$511.12.
Figure
3:
Reduc?on
in
half
of
waste
with
process
improvement.
A3
REPORTS