Austin Herrmann & Josiah Wright ETM 528 April 18, 2016 Lean Healthcare Deployment and Sustainability CH 13: Design the Future State

Slide 24/18/2016ISE 428 ETM 528 AH JW Lean Healthcare Future State Steps  Envision an Ideal State  Capture the Guiding Principles of the Ideal State  Conduct Group Problem Solving Around Waste and Current Impediments to Flow and Healing  Design an Achievable Future State  Identify and Prioritize Opportunities  Develop a Rapid Improvement Plan

Slide 3 Step 1: Envision an Ideal State  The group should come up with an ideal state by thinking out of the box  Limit the constraints on the group and allow them to come up with an ideal layout or map  Healing University’s Emergency Department came up with two maps of what an ideal Emergency Department would look like 4/18/2016ISE 428 ETM 528 AH JW Lean Healthcare Future State Page 127

Slide 4 Step 2:Capture the Guiding Principles  All ideas from the previous step should be briefed to the group  The group should then develop guiding principles to help in developing the future state  Examples of the Emergency Department’s guiding principles  Paperless operation  Happy Staff  No waiting  Guaranteed patient privacy 4/18/2016ISE 428 ETM 528 AH JW Lean Healthcare Future State

Slide 5 Step 3: Group Problem Solving  Take data collected during brainstorming and turn that to actionable items to address waste and impediments to flow and healing  Impediments to healing from the patient’s perspective  Wastes in the process  Impediments to process flow  Quantification of non-value-added and non-value- added but required process elements  Organize opportunities and find solutions that will yield improvements 4/18/2016ISE 428 ETM 528 AH JW Lean Healthcare Future State

Slide 6 Step 3: Group Problem Solving (cont.)  The Emergency Department came up with opportunities and solutions  Improved Process Develop a fast track with the PA/NP to see/treat now  Layout Changes Join areas by a common, closer access  Signage and Direction Move a security officer outside to control parking and direct as needed  Elimination of Paperwork Eliminate paper charts 4/18/2016ISE 428 ETM 528 AH JW Lean Healthcare Future State

Slide 7 Step 4: Achievable Future State  Improvement goals  Lean and pathway principles  Current state and ideal state maps  Opportunity for impact: short term goals, obvious impact, immediate patient benefit, staff benefit, inventory and supply improvement, the money.  Determine value added and non-value added time 4/18/2016ISE 428 ETM 528 AH JW Lean Healthcare Future State

Slide 8  Demand matrix is useful. See below for categories.  Think about applying the following models/methods to Step 4:  RIE’s (Rapid improvement events)  Just-do-it  Projects Step 5: Find and prioritize opportunities 4/18/2016ISE 428 ETM 528 AH JW Lean Healthcare Future State

Slide 9 Step 6: Develop a rapid improvement plan  After organizing the improvement s opportunities in step 5, formulate a timeline of sticky notes specifying each opportunity.  Think about program milestones and due dates.  Leadership is important in each role.  Compare to desired state and see if the plan makes sense  Keep track of which event, project, and Just-do-it, along with the description of each, who’s involved, and the start and finish.  Keep track of the status of the plan as you go along, and make sure to note comments. 4/18/2016ISE 428 ETM 528 AH JW Lean Healthcare Future State

Slide 10 Glossary  Guiding Principles- “items identified as key themes used in developing the ideal state” page 127  PA- Physician Assistant  NP- Nurse Practitioner  Value Added Time- Time spent that improves the outcome of the process 4/18/2016ISE 428 ETM 528 AH JW Lean Healthcare Future State

Slide 114/18/2016ISE 428 ETM 528 AH JW Lean Healthcare Future State References / Contact Information Contact Information: Austin Herrmann Josiah Wright Dean, M.L. (2013). Lean Healthcare Deployment and Sustainability. New York, NY: McGraw Hill. matrix.html