2. Steve Harrison Wednesday 20 th January 2014 Seminar Room 2 MEC Basic Queue Theory and Gantt Charts

3. Topics Variation – A recap Basic Queue theory Gantt Charts – Process Building Blocks Other Variation Concepts

4. “If I had to reduce my message for management to just a few words, I’d say it all had to do with reducing variation.” W. Edwards Deming

5. Variation – what to do? 5

6. Common Cause Variation Reduce variation: Increase precision - make the process even more reliable. Not satisfied with median performance (result): Redesign process to get a better result Special Cause Variation Identify the Cause: If Positive: Maximise, optimise, replicate, standardise. If Negative: Minimise, eliminate. 6 Application – Responding to Variation

7. Variation and Queues

8. Variation & Queues Consecutive Patients Procedure Time (Minutes) 50% 100% 80% 80% rule is the most efficient balancing waiting and waste

11. How to calculate =(((Max – Min)/100)*80 )+ Min 23 – 7 = 16 16/100 = 0.16 0.16*80 = 12.8 12.8 + 7 = 19.8 19.8 approx 20mins

12. Plan Cycle Time = 20m

13. Role Cycle Time at 80% Lung Function15m Weight & Nurse10m Dietician20m Dr20m Others15m Cycle time at 80% - PDSA 1 More Variable More Reliable

14. PDSA - Plan

16. PDSA – Do & Study

17. Demand is increasing.... More slots needed...

18. 80% = 21mins 3hrs = 8 Patients

19. 80% = 21mins 3hrs = 8 Patients 80% = 18mins 3hrs = 10 Patients

20. 80% = 21mins 3hrs = 8 Patients 80% = 18mins 3hrs = 10 Patients 80% = 14mins 3hrs = 12 Patients

21. HOW DO YOU REDUCE COMMON CAUSE VARIATION?

22. GSM

23. More Queuing....

24. Capacity required = 27

27. Capacity required = 49 (5 beds less than separate units ~£400,000)

28. Lung Cancer Clinic 28 13 + 11 = 24

29. Lung Cancer - pooled

30. And Finally - More Queuing....

31. Which is best? C Q S S S S S S

32. And Finally - Which is best? C Q Long C Q Short S S C Q Long S S S C Q Short C Q Long

33. DISCUSSION

34. THANKS!