CCS Lean - The Future for Healthcare 9-0

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Common CENTS Solutions DM&A, Inc. “Lean” The Future For Healthcare

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Lean – The Future for Healthcare William R. Klein, CEC CEO & Executive Success Coach DM&A, Inc. Tom Bunting President Common CENTS Solutions, Inc.

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AGENDA Lean – An Introduction to its Principles Lean – Best Practices for Food Service Lean – Concepts Applied to Production Software Lean – Summary and Next Steps

LEAN ROOM SERVICE : 

LEAN ROOM SERVICE William R. Klein, CEC CEO & Executive Success Coach DM&A, Inc.

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Lean Process Improvement Introduction

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TOYOTA Lean Process Improvement ELIMINATE WASTE Toyota Production System Roots

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Waste In Healthcare Foodservice Overproduction Overprocessing Idle/Wait Time Underutilized Talent Defects Excess Movement Excess Inventory Excess Transportation Lean Process Improvement

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Lean Process Improvement Toyota Basic Principles Get Quality Right the First Time Standardize Tasks for CQI Level out the Workload Replenish Based on Consumption Use Visual Control to Uncover Problems Use only Reliable, Proven Technology

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Lean Process Improvement Toyota’s Guiding Concepts Value Stream – Actions to Bring Product to Customer One Piece Flow – Elimination of Batch Constraints JIT – Just In Time (produce & replenish to demand) Takt Time – Process Tempo (available time / demand) Heijunka – Leveling out Production Kanban – Material Flow via Visual Devices Poka Yoke – Error Proof Quality Jidoka – Stopping to Build in Quality Kaizen – Continuous Improvement

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Lean Process Improvement William R. Klein, CEC CEO & Executive Success Coach DM&A, Inc. Best Practices For Food Service

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Room Service is BEST PRACTICE 38% of hospitals have some form of room service in their hospitals already

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Room Service is BEST PRACTICE Therefore, room service is considered the more green method for serving patient meals. We know how to properly plan and implement room service correctly now. And now an even more lean room service is available, which is our key point today.

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Room Service is BEST PRACTICE Customer Satisfaction Norm = 99 Percentile Improved Food Quality / Restaurant Style Menu Food & Supply Savings = $100K per 100 Beds Reduced Carbon Footprint Increased Staff Satisfaction with new FS Roles Hospitals Savings over 10 Years = $1M to $4M Remain Competitive in Healthcare Market

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Menu Restaurant style production to established par levels. Not all items need prep daily Streamline for fewer products on-hand and in freezer. Reduces inventory Simplifies ordering, receiving, and A/P process Improves product rotation Cross-use items on the line and in multiple applications.

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Equipment Properly placed equipment examples: Fryer dump station next to fryer Refrigerator drawers below cook’s table and/or grill to minimize extra steps Properly sized equipment Service level and volume must be factored in Merrychef/microwave – Use of and placement on line Cook’s line designed not just for peak times, but even more so for slow periods for one person to efficiently work the line. These periods are actually longer than peak time.

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Equipment Blast Chiller/Shock Freezer Lower Costs with Fresh Products Freeze Advance Preparation Maintain Product Quality Increase Shelf Life Improve Labor Utilization Lock in Flavor and Texture. Advance Inventory Control Assure HAACP Compliance

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Food Quality Preservation Aroma Flavor Texture Color Nutritional Value Increased Moisture/ Yield Stop Carry Over Cooking Improved Consistency and Quality Blast Chilling Benefits

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To the Operator: Waste Reduction Extended Shelf Life HACCP Compliance Advanced Food Preparation Quality Retention Improved Labor Management Improved Service Times Environmentally Friendly Blast Chilling Benefits

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Moisture Retention Original Texture Profiles of Thawed Products Vibrant Color Profiles Drastically improved Flavors Reduced Waste Advanced Food Preparation Increased Seasonal Purchasing Capabilities Improved Labor Utilization Environmentally Friendly Shock Freezing Benefits

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Indirect Air Flow to prevent food dehydration and flavor transfer. 304 grade Stainless Steel with coved corners and mirror finish for sanitation and air flow. Fans: Cast aluminum, spun balanced to ensure engine longevity, 7 blades (more than any other BC) for maximum air flow efficiency, Heated food core probe. Durable, built-to-last Heavy-duty door handles and hinges. 100% copper evaporator coil Multi-port injection of R404a refrigerant. Easy access to the evaporator coil – easy access for maintenance. UV Lamp for sterilizing the cabinet and utensils. Distinctive Features

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7% savings in Food Costs Reduce labor costs Decrease Shrinkage by 5% Reduce waste by 5-10% Lock in flavor and texture. Improve inventory control Assure HAACP Compliance Conclusion

Traditional RS Design : 

Traditional RS Design

Low Temp RS Design : 

Low Temp RS Design

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Lean Process Improvement Tom Bunting President Common CENTS Solutions, Inc. Applying Toyota’s Concepts To Production Software

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Lean Process Improvement

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Meal Management

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Bringing Hospitality to Healthcare

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Bringing Hospitality Best Practice to Healthcare Common CENTS© Solutions

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Room Service - Best Practice Restaurant Style Menus Liberalized Patient Diets Provide “What They Want” Provide “When They Want It” Regulate “Do No Harm”

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Lean Process Improvement Lean Alternative Methods PODS

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Patients Diets Allergies Orders Delivery Tracking Tray Tickets Alerts Late Orders Kitchen Display Dashboard `

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“Use visual control to uncover problems” Patient dashboard

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Dashboard – Floor View “Get quality right the first time”

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Dashboard – lEGEND “Use visual control to uncover problems”

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Patient Meal Ordering “Use only reliable, proven technology”

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Touch screens “Get quality right the first time”

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Compliance Alerts “Jidoka – stopping to build in quality”

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Nutrient Threshold A nutrient threshold alert is displayed when the nutrient limit is reached

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Order delivery Waves “Heijunka – level out the workload” Waves can be restricted by diet, location or saturation limits. Orders presorted within each wave before dispatched to kitchen.

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Order Delivery Waves “Poka Yoke – error proof”

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Order Preparation “Use only reliable, proven technology”

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Prep stations or Pods get proper menu items. Order prep is timed, monitored and highlighted. Rush orders go to the front with an icon alert. Kitchen Display System “Heijunka – level out production & one piece flow”

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Yellow – 1st Alert (Behind) “Use visual control to uncover problems”

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Red – 2nd Alert (Late) “Use visual control to uncover problems”

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“Takt Time – process tempo” Kitchen Display Timings

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Kitchen Display Timings “Use visual control to uncover problems”

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Meal Delivery Tracking “Takt Time – process tempo”

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Dashboard Update “Use visual control to uncover problems”

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Lean Process Improvement “Replenish based on consumption”

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“Replenish based on consumption” Pre-production Reports

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Kitchen Order Summary “JIT & material flow via visual devices”

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Lean Process Improvement Glenwood Regional Medical Center Patient tray cost reduced from $2.01 to $1.47 On-hand Inventory reduced from $25K to $18K No additional labor; FTE neutral Minimal kitchen renovation Press Gainey scores from 70 to 90+ percentile Annual 1st year net savings in excess of $100K Additional 2nd year savings of $50K

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Lean Process Improvement What the Experts Say: “The GEMserve system has taken room service software to the next level by allowing foodservice leaders to achieve the desired results by eliminating constraints and employing efficiencies. While the advantages of a room service program is clear with regards to increasing patient satisfaction and decreasing food costs, the additional labor associated with implementing this program has always been a negative factor.  Based on my assessment, I support your marketing strategy that GEMserve is more than software, it is truly a management tool that allows for greater control of the foodservice operation.” Sharon Cox Former Food & Nutrition Director Memorial Sloan Kettering Medical Center

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Lean Process Improvement What the Experts Say: “The (GEMserve) Room Service program is a great step towards the Lean principle of Make to Order thereby reducing and/or eliminating batch processes.  What our Healthcare Foodservice operations need are more exposure and progress towards Lean PI and having the tools that will help them.  Your software can help provide a critical tool” Shawn NoseworthyFormer Food & Nutrition Director Florida Hospital

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Lean Process Improvement Next Steps

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Lean Process Improvement Next Steps

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Lean Process Improvement What the Experts Say: “I also wanted to let you know that now that I've seen the KDS in operation, I'm impressed more than ever with your system.  When used properly (as it was at Central Maine), the KDS really enhances productivity in the kitchen and meal assembly areas.  WOW!You need to stress that issue in your sales presentations.  I never fully understood until I saw it in operation.  Now I'm a firm believer!”  Healthcare Consultant Central Maine Medical Center

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Where to Begin Call your room service coach/consultant first – Schedule a date to do the room service assessment which will provide you with a: Room service implementation plan Equipment required Equipment layout needed Staffing requirements Overall capital equipment budget Training required, savings 10 year return on investment A presentation to administration Answer all their questions and concerns Call your room service coach/consultant first – Schedule a date to do the room service assessment which will provide you with

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Room Service – Past Challenges FSDs often did not have all the information necessary to sell room service to administration. Often, the comprehensive room service assessment was not done. Design, equipment and planning was based on what other hospitals developed and no two hospitals are alike. Consequently, some hospitals opened room service without the right equipment in the right location, without the correct staffing and a menu that had more items on it than necessary to generate high customer satisfaction.

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Room Service – Past Challenges Some hospitals even tried to do room service without software. Hence, many struggled. A few failed. In our opinion, guessing at what is required to implement room service is dangerous. The guesswork is over.

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Key Points Because of the savings involved with room service, it can be recommended to admin, even during tough financial times and frozen capital budgets, to assist the hospital with the financial belt tightening process. Everything needed can be leased to bypass the need for large capital equipment budgets. Because it saves money, and is more green and lean, room service becomes a necessity, not a luxury.

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Our Team

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Lean Process Improvement Next Steps Common CENTS© Solutions Contact CCS and request a sales director’s visit Convene a GEMserve presentation with your team Have the CCS team conduct a feasibility survey Include a DM&A assessment if preferred Receive a CCS GEMserve application proposal Arrange a GEMserve customer site visit Implement the GEMserve Lean production system

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888 – 93CENTS (932-3687) WWW.CCENTS.COM Common CENTS© Solutions

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Questions & Answers Thank You! Lean Process Improvement