1. Productive Working Lara Fox Project Manager

2. What is Productive Working? Productive working involves efficient, effective and safe processes within a well organised, standardised environment where staff are motivated and empowered to make evidence based changes to continually improve their services, working environment and the care they provide. Processes Environment Staff

3. How can we create the ideal process? Process EffectiveEfficientReliableSafeStandardisedAppropriateHigh Quality Lean!

4. How should we approach making a change? Tips for Project Management: Clear Goals Measurable Baseline data Data post change Specified timeframes Defined roles & responsibilities Communicate Continuous review and improvement

5. Process Mapping: what actually happens?! Prepare meeting room (5 minutes) Nursing staff & therapists arrive (2 minutes ) Doctors arrive (5 minutes) Make tea (1 minutes) No sugar - Nurse obtains sugar ! (2 minutes) Finish making tea (1 minutes) Discuss wedding attended at weekend (3 minutes) Discuss patient 1 (4 minutes) Discuss patient 2 (5 minutes) Discuss patient 3 (4 minutes) Patient 4 notes absent – Nurse collects (3 minutes) Discuss patient 4 (3 minutes) Discuss patient 5 (4 minutes) Patient 6 test results absent – nurse collects (3 minutes) Discuss patient 6 (4 minutes) Discuss patient 7 (4 minutes) Consultant receives phone call (4 minutes) Discuss patient 8 (4 minutes) Interruption – relatives wish to speak to named nurse (4 minutes) Repeat discussion patient 8 for nursing perspective (2 minutes) Discuss patient 9 (4 minutes) Discuss patient 10 (4 minutes) Discuss actions (5 minutes) Total meeting time = 80 minutes

6. Exercise Review the process on your card What would be the ‘perfect’ process? How do your actual processes differ within your own working environment? Were there any surprises? How will you go about changing your process?

7. What needed to change in this process? We need to reduce the non value added activities (waste) Rework parts of process repeated due to errors Motion unnecessary people movement/journeys/travel Overproduction making or processing more than is necessary Over processingredundant or unnecessary processing Transport unnecessary transfer of materials or information Waitingpeople waiting for items or information to arrive Inventory/stockexcess stock or information

8. Process Mapping Prepare meeting room (5 minutes) Team arrive (2 minutes) Discuss Patient 1 (3 minutes) Discuss patient 2 (3 minutes) Discuss patient 3 (3 minutes) Discuss patient 4 (3 minutes) Discuss patient 5 (3 minutes) Discuss patient 6 (3 minutes) Discuss patient 7 (3 minutes) Discuss patient 8 (3 minutes) Discuss patient 9 (3 minutes) Discuss patient 10 (3 minutes) Confirm actions required from meeting (3 minutes) Meeting ends Total Meeting Time = 40 minutes £7,000 savings in staff hours per year (re invested into direct patient care)

9. How can we ensure a productive environment? Environmentcleantidyorganisedstandardisedsafe

10. How can we change our environment? 5S Process

11. What should we aim for? Store Cupboard Sluice

12. How can we measure effective changes in our environment? Time in motion study/activity follow Spaghetti diagrams Measles chart Process times Staff satisfaction questionnaires Photographs/videos Waste walk

13. Spaghetti Diagrams used to detail the actual physical flow and distances involved in a work process. Before After

14. Measles Chart Identifies hotspots for problems or occurrences

15. In summary....... Take the initiative Think outside of the box Don’t be afraid to make mistakes Everyone matters Share – successes and lessons learnt Improvements begin with ‘I’ “a life spent making mistakes is not only more honourable, but more useful than a life spent doing nothing." George Bernard Shaw

16. And finally....... Celebrate your successes and enjoy!!!!!!!!! Lara Fox, Project Manager Lara.Fox@hchc.nhs.uk Tel 02380 874544 Mob 07554 115593