1. LEAN Program Management: Using a
Performance Wall to integrate strategic
planning and Continuous Quality
Improvement
Kathy Tremayne, BSN, RN
Program Director
Kile Brokop, BA
Quality Analyst
Provincial Specialized Eating Disorders
Program for Children and Adolescents and
Mental Health Metabolic Program
BC Children’s Hospital

2. Disclosure
• The presenters have no relationships or involvement with industry that
may be perceived as potentially influencing the presentation of the
educational material.
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3. Learning Objectives/Overview
Participants will:
• Understand how Lean methodology has been applied at the Provincial
Specialized Eating Disorder Program for Children and Adolescents in
Vancouver, BC
• Understand how a Performance Wall can facilitate the application of Lean
dimensions of healthcare in program delivery
• How a Lean program management approach can refine and sustain a
program’s vision, mission and strategic plan
• Understand how the Performance Wall can be used to sustain and
monitor process improvements
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4. Why LEAN Process Improvement methodology at the
Provincial Specialised Eating Disorders Program
April
January
2008 November,
2009 June
~$1.5 2010
Expansion 2009 November
million December Outcome
of Lean 2010
from 2009 Measurement
Inpatient Projects Team goal
Ministry of Lean Program Framework
(10 to 14) begin in setting
Health Management and
and Day Eating process
Services begins Performance
Treatment Disorders implemented
to expand Wall
programs Program
tertiary established
(2 to 6)
care
LEAN process improvement methodologies were implemented in
2009 to ensure that access, quality and safety were maintained
and enhanced throughout the change process
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5. Why Lean Program Management at the Provincial
Specialized Eating Disorders Program?
Required
Organizational
• Based on the principles of the
Practices and
Standards
Toyota Production System,
PHSA and
Daily
Management
BCMHAS
Strategic Plans
employees are empowered to
redesign their workplace
Performance
environment and processes to
5S
Wall
Value Stream reduce waste and improve patient
Mapping
Continuous
Quality
safety, quality and outcomes.
Lean
Improvement
Program
Management
• Focused on providing value for
patient and family
Team Goal
Setting
Program
Strategic Plan • Continuous review of value stream
• Performance Wall monitors
Action Plans
Rapid Process
Improvement
processes and is hub of continuous
and Audits
Workshops
improvement
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6. The Performance Wall is the home of…
• Team Goal Visibility
• Staff and Program Accountability
• Huddles
• Addressing barriers
• Plans to address process
improvements (project
management/task tracking)
• Opportunities for dialogue
• Performance Wall Operations
• Managing data/metrics
• Process improvement monitoring
3/11/2013 6

7. Team Goal Setting: Driving Continuous Improvement
• LEAN Methodology drives goal setting
for RPIWs in the following dimensions
of LEAN healthcare: Quality, Safety,
Delivery, Cost, Satisfaction
• Program goals are aligned with
PHSA/BCMHAS strategic planning
goals
• Goals and targets set through annual
collaborative team goal setting
process and Value stream map
• Accreditation Canada ROPs are
considered in the development of
RPIW projects
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8. Staff Engagement and Accountability
• Eating Disorder team meets at
weekly stand up meeting at the
Performance Wall (10 minutes)
facilitated by Program Director,
Clinical Director, and Quality Analyst
• These meetings are an opportunity
for staff who are accountable for
process improvements to discuss
auditing, program metrics, and
develop action plans in relation to
targets with the team
• A place to celebrate success and
encourage team problem solving
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9. Performance Wall Operations: Ensuring meaningful
action towards goals
• Data-driven performance
Review Goal improvement
• Continous review of
team goals
• Data is collected from
Performance many sources: program
Action Plans
Monitoring chart audits, Quality and
Safety Department
audits, Strategic
Information
Analysis Management
3/11/2013 9

10. Case study: Ensuring timely access to tertiary services
– Performance Monitoring
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11. Ensuring timely access to tertiary services with
increased demand for services - Analysis
Assessments Completed
100 88
90 79
80
67
70 62 63
60
50
40
30
20
10
0
9
0
1
2
3
00
01
01
01
01
2012-2013 data is
-2
-2
-2
-2
-2 a projection based
08
09
10
11
12
20
20
20
20
20
on year to date.

12. How are we sustaining the change today?
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13. Lessons Learned
• LEAN program management brings the program vision and strategic plan
to life via the Performance Wall
• Performance Wall provides physical home for quality improvement
initiatives
• Performance Wall is a vehicle that encourages staff engagement and
collaboration
• Visibility and weekly stand-up meeting for monitoring facilitate
sustainment of process improvements
• Performance Wall as a “container” for managing change and visibility of
critical program metrics
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14. Discussion