Lean Shaping Design


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Lean Shaping Design

  1. 1. University of MinnesotaAmplatz Children’s Hospital Lean Shaping Design
  2. 2. University of Minnesota Amplatz Children’s Hospital
  3. 3. Learning Objectives• Review design decisions that user groups made by incorporating LEAN principles• Summarize the effects that the use of LEAN principles can have on hospital design• Appreciate the value of LEAN processes in making informed clinical design decisions
  4. 4. Project Overview• New building attached to existing facility –New building-beds, ED, surgery suites, dialysis, radiation oncology, imaging, observation/sedation, lobby, parking –All other services in existing facility• Square foot size difference of the units –Current patient care units: 15,000 square feet –Planned patient care units: 27,000 square feet
  5. 5. Project Overview• 96 all private inpatient acute care beds –48 Med/Surg/Onc beds (two -24 bed units) –24 BMT beds –24 PICU beds• Identical/same handed (right handed) patient rooms – 72 Med/Surg/Onc and BMT all identical/same handed – 24 PICU all identical/same handed• 390 square foot patient rooms –90 square foot dedicated family space – 3 zones -caregiver, patient, family
  6. 6. Project Overview• Guiding principles –LEAN –Optimize the patient and family experience through a plan and design that fosters patient and family-centered care –Design building to optimize light and visibility to facilitate way finding, healing, and safety for all –Design to facilitate collaboration and the education of the next generation of healthcare professionals –Promote the integration of patient care, education and research• On stage/off stage design concept
  7. 7. Pre-LEAN Design
  8. 8. LEAN Applied to New Design • Team workspace • Medication process • Equipment process • Personal Protective Equipment (PPE) • Satellite lab/blood bank • Nutrition center • Patient room –Location of bathroom –Nurse server for PPE’s and linen –Family space –Caregiver space
  9. 9. How LEAN Was Applied• In-house staff and external consultants• Facility layout -what is next to/close to what• Unit layout -again what is next to/close to what• Specific room layout• Data gathering• One specific example (nurses and meds-case study)
  10. 10. Tools Used• Spaghetti diagrams• Frequency counts• Observation/interviews• Door counters• Pedometers• Photo journaling
  11. 11. RN walking pattern-Current Unit
  12. 12. Adjacency Diagram5B Adjacency Diagram for OneRN 7:00 to 10:30July 26, 2007 1
  13. 13. Med Room Entries
  14. 14. First Dose Dispensing LocationUnit % Pyxis % PharmacyU5C 39.15% 60.85%UCCA 49.50% 50.60%UCCB 58.63% 41.37%U4A 46.68% 53.32%
  15. 15. Medication Storage Location U5C 67.70% Med Room Storage 32.30% Potential for Bedside Storage UCCA 54.60% Med Room Storage 45.60% Potential for Bedside Storage UCCB 73.80% Med Room Storage 26.20% Potential for Bedside Storage U4A 79.88% Med Room Storage 20.12% Potential for Bedside Storage
  16. 16. Support Function Room Entries
  17. 17. Photo Journaling
  18. 18. Existing Operations Improved Operations Exg process NewProcess RN1 Tim e m inutes 19 10 Distance feet 3768 1,925 Bottlenecks5th FLOOR MED SURG
  19. 19. Overview of Design Changes• Patient Room Layout - Same handed - Supply Storage/Nurse server - Point of use supplies in the best possible location - Distinct family and clinician space - Location of bathroom (falls, no walking around the bed for the nurse, easier to clean and stock)
  20. 20. Patient Room Layout
  21. 21. Overview of Design Changes• Overall Unit design changes - 4 Decentralized med rooms - Team Desk orientation toward patient rooms - Snack corners - Employing Technology enabler
  22. 22. Overview of Design Changes
  23. 23. Lessons Learned• What would we do differently? –Start sooner with LEAN application in design process –Provide education to the staff about LEAN application• Lessons learned – Data driven decision making using LEAN frame of work – Importance of sticking to guiding principles – Mock ups
  24. 24. University of Minnesota Amplatz Children’s Hospital
  25. 25. Questions?