Lean Healthcare by Operational Excellence Consulting

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Presentation Description

Lean Healthcare is a management philosophy based on the Toyota Production System (TPS). With Lean Healthcare, you will be able to enhance value for your customers/patients by improving service delivery and eliminating waste. Simply put, by becoming a Lean organization, you will be able to increase productivity and create greater customer value with less resources. This training presentation is especially tailored for healthcare industries. By teaching this presentation to healthcare providers and employees, they will have a better understanding of the Lean principles and approach to eliminating waste, and will be more forthcoming to lead and participate in the Lean implementation process. LEARNING OBJECTIVES  1. Understand the principles and key concepts of Lean Healthcare 2. Acquire knowledge on the key Lean methods and tools and their applications to eliminate waste and create increased value for customers 3. Identify ways to develop “Kaizen eyes” to look for improvement opportunities 4. Describe the various Lean roles To download this presentation, visit: http://www.oeconsulting.com.sg

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© Operational Excellence Consulting. All rights reserved.

Learning Objectives:

Learning Objectives By the end of the program, you would be able to: Understand the principles and key concepts of Lean Acquire knowledge on the key Lean methods and tools and their applications to eliminate waste and create more value for customers/patients Identify ways to develop “Kaizen eyes” to look for improvement opportunities Describe the various Lean roles Copyrights of all the pictures used in this presentation are held by their respective owners

Outline   :

Outline   Introduction to Lean Thinking Key Concepts & Principles of Lean Common Lean Methods & Tools Ways to develop “Kaizen Eyes” Lean Roles Sustaining a Lean Culture NOTE: This is a PARTIAL PREVIEW . To download the complete presentation, please visit: http:// www.oeconsulting.com.sg

Healthcare Imperatives:

Healthcare Imperatives Rising cost of healthcare Deaths due to medical errors Ageing population Shortage of doctors and nurses Complicated processes and systems High percentage of caregiver time spent doing paperwork Customer/patient satisfaction Employee satisfaction

How Can Lean Help?:

How Can Lean Help? Lean can increase healthcare value delivery by: Improving healthcare quality Decreasing healthcare costs It is one piece of a puzzle to solve the challenges facing the healthcare industry

Lean has been adopted in many different environments since its creation:

Lean has been adopted in many different environments since its creation Toyota Automotive Industrial products High fashion Medical devices Consumer products Aerospace Shipbuilding Pharma Food production Pulp and paper Chemicals Airlines Railways Naval operations & maintenance Healthcare Insurance Banking Retail Store Upstream E&P High Tech Consulting Law Firms Hospitality ITO/BPO Services Process industries Manufacturing Time Complexity

Results of Lean Implementation at Virginia Mason Medical Center:

Results of Lean Implementation at Virginia Mason Medical Center Source: Virginia Mason Medical Center Category 2004 Results (after 2 years of Lean) Metric Change from 2002 Inventory $1,350,000 Dollars Down 53% Productivity 158 FTEs 36% redeployed to other open positions Floor Space 22,324 Sq. Ft. Down 41% Lead Time 23,082 Hours Down 65% People Distance Traveled 267,793 Feet Down 44% Product Distance Traveled 272,262 Feet Down 72% Setup Time 7,744 Hours Down 82%

What is Lean?:

What is Lean? Value streams or processes Focused on improving process performance Clear view of end state Wide range of Lean methods and tools are available Learn-by-doing approach Culture of continuous improvement Lean is a management philosophy based on the Toyota Production System (TPS) Eliminate everything that does not add value (waste) in the customer’s/patient’s eyes Objective Focus and scope Approach and tools

Lean Principles:

Lean Principles Specify value – from the standpoint of the end customer (the patient) Identify the value stream – all process steps across departmental boundaries (the value stream), eliminating steps that do not create value Make value flow continuously – eliminate causes of delay, such as batches and quality problems Let customers pull value – avoid pushing work onto the next process or department; let work and supplies be pulled as needed Pursue perfection – through continuous improvement

What Lean IS NOT:

What Lean IS NOT Laying off employees by the bus load Only applies to manufacturing companies A cost reduction program Delivering less or working harder Just a set of “tools” like 5S, kaizen events, etc. Automation or implementing an IT system Another “extracurricular activities”

Lean Facilitates a Culture Change:

Lean Facilitates a Culture C hange Work Systems & Processes Behavior Attitude Culture The way we act The way we think Waste elimination

Lean Management Framework (a.k.a. Toyota Production System):

Lean Management Framework (a.k.a. Toyota Production System) Source: Adapted from Toyota Production System Stability Heijunka Standardized Work Kaizen Just-In-Time Continuous flow Takt time Pull system Flexible workforce Jidoka Separate man & machine work Abnormality Identification Poka yoke Goals: highest quality, lowest cost, shortest lead times Involvement Stability Standardization Just-In-Time Jidoka Involvement 1 2 3 4 5 1 2 3 4 5 Focuses on Quantity and “Flow” Focuses on Quality and Prevention

Benefits of Lean Healthcare:

Benefits of Lean Healthcare Lean Healthcare cuts out wasted time and resources Increases the process efficiency of admitting and treating patients Improve direct patient care processes Allows more patients to be treated Allows hospitals to leverage existing assets and generate higher margins

Value:

Value Value Added It is an activity It is requested by or important to the patient (i.e. something the patient is willing to pay for) It changes the thing being processed It is done right the first time (i.e. without any rework or waste)

“There is nothing so useless as doing efficiently that which should not be done at all.” Peter Drucker :

“There is nothing so useless as doing efficiently that which should not be done at all.” Peter Drucker

Eight Types of Healthcare Waste:

Eight Types of Healthcare Waste Over-production Producing more, sooner, or faster than required Inventory Storing excess drugs/supplies, including unnecessary equipment and resources Transportation Unnecessary movement of patients, specimens and supplies Defects Errors or corrections due to work not being done correctly Over-processing Putting more work into a process than required Motion Extra physical/mental motion that does not add value Intellect Not using employees full intellectual contribution Waiting W aiting for another person, process or equipment Waste

Types of Waste:

Types of Waste “Just in case” blood tubes drawn from patients but not used Patients seen by MD faster than can be treated by chemo causing delays Creating reports that no one needs or making extra copies Purchasing drugs and supplies before they are needed Providing more information than the customer needs Over-Production

Types of Waste:

Types of Waste Patients waiting due to schedule exceeding capacity Specimens waiting in batches for testing in the lab Waiting for patients, beds, equipment, operating rooms, information, etc. Seeking clarifications (due to unclear communications) Equipment/System downtime Out-of-stock drugs and supplies Waiting

Examples of Value-Added Activities in Healthcare:

Examples of Value-Added Activities in Healthcare Admission Discharge Providing treatment (e.g. emergency, outpatient, surgical, medical, therapy, etc.) Nursing care process Medication process Staff scheduling to match patient loads All patient scheduling processes, such as inpatient and outpatient Ancillary testing, such as lab and x-ray Core process improvement Source: Robert Chalice, “Improving Healthcare Using Toyota Lean Production Methods: 46 Steps for Improvement”

“We must always keep in mind that the greatest waste is the waste we don’t see.” Shigeo Shingo, a Japanese industrial engineer and expert on the Toyota Production System:

“We must always keep in mind that the greatest waste is the waste we don’t see.” Shigeo Shingo, a Japanese industrial engineer and expert on the Toyota Production System

Lean Thinking Philosophy:

Lean Thinking Philosophy Identify and eliminate all activities that are waste. Focus on optimal flow throughout the process. Focus on creating value for customers/patients. Current State Future State Identify Waste “True North ” Value Added Time = Lead Time Full of Waste, Variation, and Rigidity Eliminate Waste

What is 5S?:

What is 5S? Principles General Description 1S Sort Remove what is not needed and keep what is needed 2S Set in Order Arrange essential items in order for easy access 3S Shine Keep things clean and tidy; no trash or dirt in the workplace 4S Standardize Establish standards and guidelines to maintain a clean workplace 5S Sustain Make 5S a habit and teach others to adhere to established standards

Laboratory – Before & After 5S:

Laboratory – Before & After 5S A laboratory work area before and after conducting 5S Sort and Set In Order. Clutter and unused items have been removed leaving only what is needed. Before After

2S : Set In Order - Examples:

2S : Set In Order - Examples Drugs are organized for easy retrieval A neatly arranged Cardiac table A neat table setup for blood donations Form submission boxes for walk-in blood donors and those by appointment

Everyday Visual Management:

Everyday Visual Management

Daily Management Meetings:

Daily Management Meetings Agenda Yesterday’s issues Lessons learned Manpower status Update from top management Lean activities Today’s target and actions

Value stream mapping provides an overview of the end-to-end administrative process:

Creates an end-to-end view of the system Demonstrates interaction between material/work and information flow Provides a common visual language for understanding a complex system Supplier/ Customer Management Control Customer Work & Information Flow Information flow Value stream mapping provides an overview of the end-to-end administrative process

Heijunka – Lean Levers Can Be Applied to Reduce Waste:

Heijunka – Lean Levers Can Be Applied to Reduce Waste Segmenting complexity Redistribute activities Flexible manpower systems Reduce incoming work Reduce NVA work Standardize operations Form separate channels for complicated tasks so that simple ones are not held up Align activities with appropriate skill set and group Balance processing capacity with the ongoing demand by moving people to where the work activity is Eliminate tasks from a person by reducing the actual work activity arising Eliminate work that does not directly add value to the end customer Establish best practices to execute a task 1 2 4 5 6 7 Pool resources Utilize existing skills and resources to reach economies of scale 3

Quick Setup:

Quick Setup Quick setup or SMED (Single Minute Exchange of Dies) are used to reduce the setup or changeover time for operating rooms, MRI machines or ICUs The pitstop concept of quick changeovers can be applied to operating rooms to reduce setup time

Examples of Andon:

Examples of Andon Andon cord at patient’s bed Andon system for customer service Andon cord placed at the toilets to facilitate patients to call for help if needed Andon for monitoring of patients’ vital signs

PDCA Five–step problem solving process:

PDCA Five–step problem solving process

Example of 5 Whys:

Example of 5 Whys Why? Because… 1 Why is Tom injured? …he had a fall 2 Why did he fall? …the floor was wet 3 Why was the floor wet? …there was a leaking valve 4 Why was the valve leaking? …there was a seal failure 5 Why did the seal fail? …it was not maintained 1 3 4 5 2 A continuum of causes

A Simple Lean Implementation Roadmap:

A Simple Lean Implementation Roadmap Create Awareness Build Capability Operations Management & Improvement Lean Thinking Training Lean Leadership Training Build Lean Activity Board Kaizen #1: 5S Kaizen #2: Waste Elimination Value Stream Mapping for K ey Processes Train-the-Trainer Training Information Sessions for Whole O rganization Senior Management Awareness Kaizen #3: Standardization Month 1 Lean Methods & Tools Training Month 3 Month 2 Daily Management Meeting Lean Update in Monthly Newsletter & Intranet

Sustaining a Lean Culture:

Sustaining a Lean Culture Management commitment Alignment to vision and mission Availability of resources Address “what is in it for me” Success measures and KPIs Management review Rewards and recognition

About Operational Excellence Consulting:

About Operational Excellence Consulting

About Operational Excellence Consulting:

About Operational Excellence Consulting Operational Excellence Consulting is a management training and consulting firm that takes a human-centered approach to helping organizations in the public and private sectors to work smarter and grow faster. The firm’s mission is to create business value for organizations through innovative operational excellence management training and consulting solutions. OEC takes a unique “beyond the tools” approach to enable clients develop internal capabilities and cultural transformation to achieve sustainable world-class excellence and competitive advantage. For more information, please visit www.oeconsulting.com.sg

END OF PREVIEW To download this presentation, please visit: www.oeconsulting.com.sg:

END OF PREVIEW To download this presentation, please visit: www.oeconsulting.com.sg

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