Lean Healthcare Deployment and Sustainability Overview Kristina Hanson 2/19/2014

Examples of 8 Types of Waste Type of Waste Example Defects Medication error, wrong patient or procedure, missing information Overproduction Drawing too many samples, extra tests Waiting Waiting to see a doctor, for a procedure, a bed, testing, etc. Not Utilizing People’s Abilities No empowerment, “check your brains at the door” mentality Transportation Moving samples, specimens, patients for testing or treatment, equipment, etc. Inventory Pharmacy stock, supplies, samples, paperwork in process Motion Searching for patients, medications, charts, etc. Excess Processing Multiple bed moves, testing, excessive paperwork ISE 428 ETM 591 KLH Lean Healthcare Overview Spring 2014

Visual of 8 Types of Waste http://www.goleansixsigma.com/8-wastes/ ISE 428 ETM 591 KLH Lean Healthcare Overview Spring 2014

The Value Stream Analysis Event VSA is a powerful tool to analyze clinical and business processes and to identify opportunities for improvement Analysis usually takes place over a 2-3 day with a cross-functional team VSA Event http://www.timewisems.com/lean_manufacturing_le201.html ISE 428 ETM 591 KLH Lean Healthcare Overview Spring 2014

ISE 428 ETM 591 KLH Lean Healthcare Overview 1. Set it up. Occurs prior to the event Gets commitment from senior leadership team and the executive with responsibility of healing pathway Document a formal charter (identify team members and objectives) Schedule and prepare for 2-3 day event ISE 428 ETM 591 KLH Lean Healthcare Overview Spring 2014

2. Understand the Current State Document SIPOC: Suppliers – inputs – process – outputs – customers Identify: Value and how to measure it Wastes in the process Impediments to healing in the process Document a current state map ISE 428 ETM 591 KLH Lean Healthcare Overview Spring 2014

3. Envision an Ideal State “Ideal” suggests that this is not an achievable state in the near long term Generates creative thinking and ideas among team Identify guiding principles that were implicit in the ideal design ISE 428 ETM 591 KLH Lean Healthcare Overview Spring 2014

4. Design an Achievable Future State Ideal state serves as a starting point Consider constraints to their full implementation Design an achievable future state Prioritize the improvement activities ISE 428 ETM 591 KLH Lean Healthcare Overview Spring 2014

5. Develop and Execute a Rapid Improvement Plan Document the opportunities identified for achieving the future state Just Do Its (JDI) Rapid Improvement Events (RIE) Projects Determine the best approach for achieving all three types Document them in a rapid improvement plan ISE 428 ETM 591 KLH Lean Healthcare Overview Spring 2014

ISE 428 ETM 591 KLH Lean Healthcare Overview GLOSSARY Value Stream (page 9) A series of one or more processes that result in the delivery of a service or a product Waste (page 24) Eight types: Defects, Overproduction, Waiting, Not Utilizing People’s Abilities, Transportation, Inventory, Motion, Excess Processing Value Stream Analysis (page 25) Refers to the process of analyzing a value stream to implement improvements Ideal (page 26) Suggests that it is not an achievable state, at least in the near long term ISE 428 ETM 591 KLH Lean Healthcare Overview Spring 2014

ISE 428 ETM 591 KLH Lean Healthcare Overview References / Contact Information   Dean, M.L. (2013). Lean Healthcare Deployment and Sustainability. Pages 24-26. New York, NY: McGraw Hill. - Kristina Hanson Kristina.L.Hanson@live.mercer.edu ISE 428 ETM 591 KLH Lean Healthcare Overview Spring 2014