1. SMART Wheelchair & Seating Kaizen November 2008

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

3. 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

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

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

6. 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

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

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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. Before

16. After

17. During

18. After

20. Before

21. After

22. Livingston – Main Wheelchair Store £15K investment in improvements

23. 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

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

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