PowerPoint Presentation

Lean for Doctors21st June 2013

Medical Leadership Symposium

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Workshop OverviewExperience of Lean in HSCOverview of Principles and MethodologyHow you might apply Lean in your areaFurther information and support

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Overview of Lean

Lean the relentless pursuit of the perfect process through waste elimination

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The focus is better, safer, more efficient processes for patientsThe people doing the work identify and make the improvements

Lean in HSC>50 projectsTissue Pathology; Radiology; Chemotherapy; Haematology; Fractures; Cardiology; ED; MAU; Respiratory; Plastics Capacity building in organisations virtual support teams

Overview of Lean Principles and Methodology

Establish Flow

ImplementPull

Work to Perfection

1. Specify Value Map the Value StreamLean ThinkingLean The 5 Principles

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The Project FrameworkPreparation

Preparation work4 6 weeks VSMKaizenSustainabilityProject TimelineTraining the core teamDeveloping a project charterData CollectionStakeholder Interviews with staff and patientsDirect process observations

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AIM: To improve the patient journey by enhancing flow and efficiency

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Establish Flow

ImplementPull

Work to Perfection

Specify Value 2. Map the Value StreamLean ThinkingLean The 5 Principles

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The Project FrameworkProject TimelineValue Stream Mapping = 2 day eventPreparation workVSMKaizenSustainability

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The 8 Wastes in HealthcareWaiting: Patients waiting for bloods, consultation, medicines from Pharmacy; doctors waiting for patientsInventories: Batches eg scheduling 4/5 patients per appointment slot; lab samples batched; Defects: Missing, incorrect Chemo charts Excessive Processing: Duplicating manual and computer informationOverproduction: Too many blood tests Movement: Looking for patients, missing charts Transportation: Moving patients around the UnitUnder-utilisation: Doctors carrying out procedures which Nurse Specialists could do

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43 suggested improvements

3. Establish Flow4. ImplementPull

Work to Perfection

Specify Value Map the Value StreamLean ThinkingLean The 5 Principles

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The Project FrameworkProject TimelineKaizen = 5 day try out of improvementsPreparation workVSMKaizenSustainability

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Establish Flow

ImplementPull5. Work to Perfection

Specify Value Map the Value StreamLean ThinkingLean The 5 Principles

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The Project FrameworkProject TimelineSustainability = 6 week periodPreparation workVSMKaizenSustainability

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Applying Lean Thinking to Your Work

Identifying OpportunitiesA process that would benefit from LeanIdentify main wastes

The 8 Wastes in HealthcareWaiting: Patients waiting for doctors; doctors waiting for colleagues/test resultsInventories: Stock levels; batchingDefects: Medication errors, missing information Excessive Processing: Multiple/overcomplicated assessments, duplicating manual and computer entriesOverproduction: Too many tests Movement:, Safari ward rounds; missing charts or equipmentTransportation: Patients travelling for procedures that could be conducted closer to homeUnder-utilisation: Doctors carrying out tasks that could be done by other clinical or admin staff

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The Difference a Doctor MakesPositiveIncreased speed of implementationBeing visible at VSM; Kaizen = spur to actionImproved working with non medical colleaguesNot so Positive!Sustainability not adhering to agreed role changesImpact on other team members - whats the point?Paying lip service focusing on personal agendas

Further Information and Support

Information and SupportTransforming Health Care: Virginia Mason Medical Centers Pursuit of the Perfect Patient Experience Charles Kennywww.leanhealthcareacademy.co.uk Support within organisations virtual teamsLeadership Centre:Case Studies Trust eLearning sitechristine.mcgowan@leadership.hscni.net