This document discusses lean management and lean in the healthcare service industry. It provides examples of different types of waste in healthcare, such as defects, overproduction, inventory, movement, excessive processing, transportation, and waiting. It then discusses a case study of Virginia Mason hospital's lean implementation journey, which resulted in benefits like improved patient safety, one-stop cancer care, faster revenue cycles, and positive net margins in primary care. The summary section recaps lean in service, the service context and concept, examples of waste, and Virginia Mason's lean journey.

1. Lean Management

2. Lean in Service

3. Agenda
Background
Lean in Healthcare Service Industry
Summary

4. Background
• Background
• Service context
• Service concept
• Value demand and failure demand

5. Lean in Healthcare
4

6. Types of Waste
Waste Type Examples
Defects Re-sticks, redraws, medicine errors
Overproduction Blood draws done early to accommodate lab schedule
Inventory
Patients waiting for bed assignments
Excess inventory of supplies, bed sheets, etc.
Lab samples batched
Movement
Looking for patients
Missing medicines
Missing charts or equipment
Excessive Processing
Multiple bed moves
Retesting
Transportation
Excessive transporting patients for tests
Moving medicines and supplies
Waiting
Patients waiting to be seen by the doctors
Patients waiting for discharge
Doctors waiting for test results
Underutilization Nurses transporting patients to X-ray

7. Case Study - Virginia Mason
• Virginia Mason’s Vision
• Waste reduction
• Benefits achieved and success stories
o Patient safety improved
o One-stop care for patients with cancer
o Getting back to nursing
o Hyperbaric center increases patient capacity
o Express treatment in the emergency department
o Faster revenue cycle
o Primary care achieves positive net margins

8. Summary
Lean in service
Service context and concept
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Waste examples
Virginia Mason’s Lean implementation journey

9. Knowledge Check

10. Knowledge
Check
A.
B.
C.
D.
1
What type of waste is “Patients waiting to be seen by the doctors”?
Overproduction
Waiting
Inventory
Underutilization

11. Knowledge
Check
The correct answer is
A.
B.
C.
D.
1
Patients waiting for doctor to be seen is waiting type of waste. If the doctor is waiting for patients then it would be
underutilization.
B
What type of waste is “Patients waiting to be seen by the doctors”?
Overproduction
Waiting
Inventory
Underutilization

12. Knowledge
Check
A.
B.
C.
D.
2
What type of waste is “nurses transporting patients to X-ray”?
Overprocessing
Movement
Defect
Underutilization

13. Knowledge
Check
The correct answer is
A.
B.
C.
D.
2
Nurses transporting patients to X-ray department is an example of underutilization of skills. This work can be done by
people with lower skills than nurses.
D
What type of waste is “nurses transporting patients to X-ray”?
Overprocessing
Movement
Defect
Underutilization