This document summarizes a Lean journey in an endoscopy unit over two years that resulted in significant financial and quality improvements. Key points: 1) Applying Lean principles like eliminating waste and improving workflow led to a $3 million annual revenue increase from 250-700 more procedures per month with the same resources. 2) Additional savings beyond the procedure room brought the total return on investment to over $3 million annually. 3) Implementing tools like visual workplace organization, Just-in-Time supply management, rapid improvement events, and a focus on continuous improvement helped empower staff and establish a culture of problem-solving that sustained improvements.

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ISQua’s- 32nd International Conference
4th -7th October, 2015 - Doha
Lean Journey in an Endoscopy Unit
(2013-2015)
By
Anastasia Sayegh
Certified Lean Master
Lean Enterprise Inc., Canton Ohio
Middle East Office (LB)

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• The ROI from this two-year Lean journey in
the Endoscopy unit is $3 million in revenue
growth per year as a result of the increase in
volume of 250 to 700 procedures per month
with the same resources.
• Note that the procedure room accounts only
for 60-70% of the total ROI of the project as
other savings were also achieved.

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• Presentation Goals.
• Lean Definition.
• Project Financial & non Financial Outcomes.
• CI - Developing Problem Solving Capabilities
Agenda

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Goals
• Lean is about People
Leadership empowers
Employees to deliver
Value to the Patient
• Value stream concept (the nature of the CI event)

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What is Lean?
“Lean is having the best process in place right Now”
Lean Enterprise
=
Process Excellence

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Lean Enterprise
Process Excellence
Employee Participation
Increased Profits
Customer Satisfaction
Quality
Improvement
Asset
Utilization
Waste
Elimination
Space
Utilization
Cash
Generation
Rapid
Response
Cost
Reduction
Productivity
Improvement
Design
Excellence
Employee
Utilization
Information
Streamlining
On-Demand
Response

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Value Stream Map (VSM)
-Colonoscopy-
• Poor workplace organization
• Supply not available in the room
• Long set up time
• IV reinsertion
• Over stocked supply in unit store
• DOB discrepant with Matrix Patient Index
• MPI and ID generation
• Checking billing 3 times
• Cashier, billing location
• Recovery room full

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WASTE Types

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Take Away Message I
• Quality is not limited to defects /errors
only. There are 7 other types of waste that
may define the quality of our work.
• Get close to the “High Reliable
Organization” that we should all be trying
to achieve.

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Lean Enterprise
Value - Value Stream - Flow - Pull - Perfection
A Kaizen is a...
Rapid Improvement Event

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Kaizen events
The Unit head prioritized Supply and Material
“ Mastering supply in Health Care is key
element, capable to manage not only
Endoscopy issues but the entire hospital
issues as well”.

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Kaizen events (cont’)
6S Kaizen’s

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More Kaizens
• TPM,
• Quick C/O,
• Error Proofing Kaizens
700,000$ in real saving in less than a year

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Procedure Room
pre/post Kaizen(s)
All this is achieved with
The same resources

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Lean Financial Impact
What is unique to the Lean methodology to
achieve these staggering results?
WASTE...
Waste consumes up to 60% of our $revenue
GROW = Get Rid Of Waste

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Take Away Message II
“Lean can help you
to achieve your hospital’s
financial improvement
Expectations”

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Lean non Financial impact
• Bloc schedule
• Visual workplace
• Billing/patient satisfaction
• Infection control
• Documentation /Pt education
• Patient flow in the endoscopy
• Medical indicator
• Staff development

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6S/JIT tools
• 6S, Kaizen and JIT enhanced:
- Communication.
- Collaboration/Cross-functional cooperation.
“Value streams are flowing without interruption now”, that is the
greatest benefit of the endoscopy project, said Head of the Unit.
• Leadership support for practicing 6S encouraged staff to:
- Be less resistant and change behaviors for better productivity.
- Seek higher technical education and CI skills.
- Build quickly a culture of continuous improvement and sustain it.
“Another big advantage that Lean brought to the Endoscopy Unit was
helping people to become Lean thinkers”. added the Unit head

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Error Proofing /Jidoka
Educating and training staff on: “do it right
the first time”, it facilitated:
- Autonomy.
- Employee Creativity.
“Staff took control of their work and improved it”

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Take Away Message III
Lean must move
from Project
Focus to
Habitual
Behavior to
Culture ChangeProject
Focus
Habitual
Behavior
Culture
Change

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Last Message
CI = Kaizen = PDCA = A3
Develop Problem Solving Capabilities.

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CI/Kaizen
Kaizen events help:
• Understand your organization’s challenges
while thinking differently.
• Learn how to solve future problems.
• Achieve revenue and cost reduction targets.

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Grow the Kaizen Spirit in
Every Person
“Small Incremental improvements will
lead us from process Improvement to
significant process Innovation ”.

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Summary
• If Lean can help to achieve financial and non
financial goals…
• If lean can boost the sense of ownership,
autonomy and loyalty…
• If Lean can provide safe, flexible & high quality
care while meeting demand…
Q - What should you do to achieve these gains?
A - Lean 4th Rule: Educate

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Thank You!
anastasia.sayegh@leanvalue.com