MLS2013 (www.medleadsymposium.co.uk) workshop led by Christine McGowan, Principal Consultant at the HSC Leadership Centre.

1. Lean for Doctors
21st June 2013
Medical Leadership Symposium

2. Workshop Overview
 Experience of Lean in HSC
 Overview of Principles and
Methodology
 How you might apply Lean in your area
 Further information and support

3. Overview of Lean

4. Lean …
“ …the relentless pursuit of
the perfect process through
waste elimination …”

5. The focus is better, safer, more efficient processes for
patients
The people doing the work identify and make the
improvements

6. Lean in HSC
 >50 projects
– Tissue Pathology; Radiology; Chemotherapy;
Haematology; Fractures; Cardiology; ED; MAU;
Respiratory; Plastics
 Capacity building in organisations – virtual
support teams

7. Overview of Lean Principles
and Methodology

8. Establish
Flow
Implement
Pull
Work to
Perfection
1. Specify Value
Map the
Value StreamLean
Thinking
Lean – The 5 Principles

9. The Project Framework
Preparation
Preparation work
4 – 6 weeks
VSM Kaizen Sustainability
Project Timeline
• Training the core team
• Developing a project charter
• Data Collection
• Stakeholder Interviews with staff and patients
• Direct process observations

10. AIM: To improve the patient journey by enhancing
flow and efficiency

11. Establish
Flow
Implement
Pull
Work to
Perfection
Specify
Value
2. Map the
Value
Stream
Lean
Thinking
Lean – The 5 Principles

12. The Project Framework
Project Timeline
Value Stream Mapping = 2 day event
Preparation work VSM Kaizen Sustainability

13. The 8 Wastes in Healthcare
 Waiting: Patients waiting for bloods, consultation,
medicines from Pharmacy; doctors waiting for
patients
 Inventories: Batches eg scheduling 4/5 patients
per appointment slot; lab samples batched;
 Defects: Missing, incorrect Chemo charts
 Excessive Processing: Duplicating manual and
computer information
 Overproduction: Too many blood tests
 Movement: Looking for patients, missing charts
 Transportation: Moving patients around the Unit
 Under-utilisation: Doctors carrying out procedures
which Nurse Specialists could do

14. 43 suggested
improvements

15. 3. Establish
Flow
4. Implement
Pull
Work to
Perfection
Specify
Value
Map the
Value StreamLean
Thinking
Lean – The 5 Principles

16. The Project Framework
Project Timeline
Kaizen = 5 day try out of improvements
Preparation work VSM Kaizen Sustainability

17. Establish
Flow
Implement
Pull
5. Work to
Perfection
Specify
Value
Map the
Value StreamLean
Thinking
Lean – The 5 Principles

18. The Project Framework
Project Timeline
Sustainability = 6 week period
Preparation work VSM Kaizen Sustainability

20. Applying Lean Thinking to
Your Work

21. Identifying Opportunities
 A process that would benefit from Lean
 Identify main wastes

22. The 8 Wastes in Healthcare
 Waiting: Patients waiting for doctors; doctors waiting for
colleagues/test results
 Inventories: Stock levels; batching
 Defects: Medication errors, missing information
 Excessive Processing: Multiple/overcomplicated
assessments, duplicating manual and computer entries
 Overproduction: Too many tests
 Movement:, “Safari” ward rounds; missing charts or
equipment
 Transportation: Patients travelling for procedures that
could be conducted closer to home
 Under-utilisation: Doctors carrying out tasks that could be
done by other clinical or admin staff

23. The Difference a Doctor Makes
Positive
 Increased speed of
implementation
 Being visible at VSM;
Kaizen = spur to action
 Improved working with
non medical colleagues
Not so Positive!
 Sustainability – not
adhering to agreed
role changes
 Impact on other team
members - “what’s the
point?”
 Paying lip service –
focusing on personal
agendas

24. Further Information and
Support

25. Information and Support
 “Transforming Health Care: Virginia Mason Medical
Center’s Pursuit of the Perfect Patient Experience”
Charles Kenny
 www.leanhealthcareacademy.co.uk
 Support within organisations – virtual teams
 Leadership Centre:
– Case Studies – Trust eLearning site
– christine.mcgowan@leadership.hscni.net