workforce implications of lean principles in action: front end laboratory re-design christine...
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Workforce Implications of LEAN Principles in action: Front End Laboratory Re-DesignChristine MorrellDr Wynne WilliamsAberTawe BroMorgannwg University NHS Trust
Improvement Project
Six Sigma Uses statistical tools to uncover root
causes and reduce variation
LEAN Seeks to improve flow and eliminate waste
Speculation
“There is a lot of speculation and I guess there is going to continue to be a lot of speculation until the speculation ends”
George W. Bush
Eliminate Waste- SWIMTOOT
Scrap (It just doesn’t meet expectations) Waiting (Things just don’t happen when they should) Inventory (Keeping stuff on-hand when it isn’t required) Motion (Excess movement -person/material -within a
process) Transport (Shipping stuff to different locations) Over Production (Doing more than you need to -output of
a process) Over Processing (Doing more than you need to -within a
process) Talent (Using skilled people to do unskilled jobs)
Sample Reception - Lab Redesign Phase 1
Consultation Process
Independently staffed and managed At Front of House
Design a laboratory
Ideas
“ We have nothing against ideas. We’re against people spreading them.”
Augusto Pinochet. (former military leader of Chile, accused of fraud and human right abuses)
HaematologyMLA
Clinical Biochemistry
MLA
Clerical Staff
Phlebotomist
Autoclave Operative
PathologySupportWorker
Pathology Support Worker
Options
Phlebotomist
Pathology Support Worker
Pathology Support Worker excluding Phlebotomy
Multifunctional Workers
Must be well trained
Insulation against absenteeism and vacations
Creating a Continuous Improvement Mindset
Band 3 & 4 staff
Band 3 Phlebotomy Training/MLA Senior Phlebotomist/MLA
Band 4 Office Manager
Specimen Reception Manager
Key Competences H.R. Management Training Quality
Skills Analysis
Training and Competences
Training Logs Competence Assessments Evidence of Continuous development
e.g. Attendance at CPD sessions Lean Team Presentation Involvement in preparation of Laboratory
Instructions
The Lean Workforce
Flexible Motivated Aligned to Demand Appropriate Competences
Access to Appropriate Training
Putting People First
Improve employee morale through • Using Lean to solve “every
day”problems • Improved lab performance and patient
care • Staff empowerment via Lean methods
Flexible working - A4C (37.5h)
Introduction of Flexible working Early starts and finishes Shortened Lunch Breaks Late starts and finishes
Visual Clues: Staffing Levels
Work Force Implications
Managing Expectations Structure on to which hang
Competences Appropriate Extended Roles
Healthcare Scientist Career Framework
“To those of you who have received honours, awards and distinctions, I say well done. And to the ‘C’ students, I say, you too can be President of the United States
George W. Bush (US President)
Challenges
Pathology: towards a competence based workforce
A report of the Pathology Profiling Project. May 2008
Improvement in TAT
Turnaround Times: GP & OPD U&E
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TAT: “U&Es - Cold
2005/06 4.25
2006/07 4.62
2007/08 3.03
2008/09 2.1
Troponin T
Turnaround Times :Troponin T
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Thankless Tasks
“It’s not so much a thankless task. It’s more a job with no thanks.”
Colin Baker. Dr Who.
The Lean Workplace
Delivery of a Quality Service in the most cost effective manner