SMART Wheelchair & Seating Kaizen November 2008

To identify areas for process improvement To Improve patient experience Reduce waiting times Improve access Improve equipment options Objectives

Protected time Cross-service representation Process mapping pre-event Day one - extensive workout –Identify issues using 3 process maps –Group into common themes –Identify potential solutions –Prioritise solutions Approach

Days 2 – 4: ‘try storming’ –‘5S’ in 4 store areas –Sort, Set in order, Shine, Standardise, Sustain Final Day - Action plan

Action Plan 28 actions identified –Admin procedures –Patient pathway –Improved use of ReTIS –Stores Many actions completed within the week

Streamlined referral process: Goal: Shorter referral – assessment period Issues: – Incomplete referrals – Separate referrals for each service – Adult Wheelchair – Children’s Wheelchair & Seating – Adult Seating – Person dependent Administration Procedures

Actions Referral Group Number of different referral forms reduced Creation of address Access to SCI Gateway

Results SMART Referral form Single point of contact Reduction in incomplete referrals Reduction in printing

Patient Pathway Creation of combined adult and children power chair clinic Children: –Maximum wait reduced from 11-4 weeks Adult: –Maximum wait reduced from 8-5 weeks

One-stop adult clinic re-established due to modernisation funding Chair storage facilitated through 5S Many patients attending clinic are receiving a chair at clinic –Adult 42% –Children 20% Patient Pathway

Improved Use of ReTIS ReTIS ‘wish list’ Standardisation of ReTIS use across services –Adaptations to ReTIS (new job types, screen appearances etc) –Staff refresher training More joined up working

Improved Use of ReTIS Accurate data entry of wheelchair stock: –Chair locations and status in ReTIS ‘untrustworthy’ –Large data cleansing exercise –New store locations created in ReTIS Reduced stock errors –Quicker patient provision

Improved Use of ReTIS Still ‘to do’ list ReTIS to be available at point of wheelchair receipt (remote store) –Quicker stock availability Provision of networked laptops for domiciliary visits –More efficient use of staff time

Stores 5S in all SMART stores: –SMART wheelchair (children’s) –SMART wheelchair (adult) –SMART main component store –Livingston main store Removal of obsolete / excess equipment

Before

After

During

After

Before

After

Livingston – Main Wheelchair Store £15K investment in improvements

Overall Summary Improved referral to assessment process Combined children and adult power chair clinic Re-establishment of one-stop clinic Integrated processes across services Enhanced team work

Benefits yet to be realised Shorter waiting times with: –Staff recruitment / training –Release of modernisation funds

All SMART staff ReTIS team Lean In Lothian team NHS Lothian Edinburgh CHP