Introduction

to Lean

Objectives

After completing this training, the learner will

be able to:

• Explain what Lean is

• Understand Lean tools, including: Value

Stream Mapping, waste identification,

Kaizen, Kanban, and 5S

What is Lean?

Providing the most value from

the customer’s perspective while

consuming the fewest resources

and utilizing the talents of the

people who do the work.

Why Lean?

Improved QualityCost Reductions

Without Layoffs

Error Prevention Improved

Patient Safety

Reduced Waste

Increased

Employee Engagement

Lean Thinking1. Specify value in the eyes of the

customer.

2. Identify the value stream and

eliminate waste.

3. Make value flow at the pull of the

customer.

4. Involve and Empower employees.

5. Continuously improve in pursuit of

perfection.Source: Lean Thinking, Womack and Jones 1996

Lean Thinking in Practice

1. Do our work every day in a

standard way that we created.

2. Be alert to things going wrong.

3. Fix the problem now.

4. Find and fix the root causes of

the problem.

In a Lean organization,

each of us has 2 jobs:

•Do the work.

•Improve the work.

LEAN METHODOLOGY

Value Stream:All of the steps, both value-

added and non-value-added,

required to bring a specific

product/service through a

process

Value vs. Wastean activity that the

customer directly

benefits from or

uses and is willing

to pay for

an activity that

is unneeded,

unwanted, or

involves

excess effort

Spaghetti Diagram

Podiatrist walked 670 feet

for a single procedure prep

A Value Stream Map Is:

A visual representation of

a process used to reveal

waste and problems with

flow.

Sample Value Stream Map:

Pathology Specimens

Sample Value Stream Map:

Pathology Specimens

Sample Swimlane Map: New Hire Onboarding Process

Sort Barriers into “Buckets”

New Hire Onboarding

Root Cause Analysis

The root cause is the

underlying condition or

aspect of the system

that led to the error.

Example Fishbone Diagram

5 Whys

Create a SMART goal

PDCA Cycle

• Plan – Do – Check – Act

• Select a single point to change, otherwise

you won’t be able to determine the source

of results

• Be sure to do the full PDCA, not just PD

• The only experiments that truly fail are

those that you never run and those that you

run without looking at the results

Standard Work:The current one best documented

way to safely, effectively, &

efficiently complete an activity

with the proper outcome and the

highest quality in a repeatable and

reproducible manner

Opportunities for Standard Work

Standardizing phlebotomy carts to reduce waste

Lean in Action at Riverside

Hematology/Coag

Chemistry/Tox

Accessioning

Product Flow

156 feet

in 10 minutes

338 feet

in 10 minutes

Core Tech

(all 4 main

instruments)

Product Flow

Specimen travel distance:

146 feet -> 67 feet

(54% decrease)

Potassium TAT:

74 min -> 43 min

(42% decrease)

Results in Chart by 7 AM:

62% -> 92%

(30% increase)

Freed up 228 square feet of space

No staff reductions

Lean in Action at Riverside

LEAN TOOLS

Kaizen

Suggestion Card

Sample Kaizen Board

Title: Isolation Equipment

Before After

PPE boxes that used to hang on the doors didn’t

have room for extra isolation supplies to be stored

and we would run out frequently.

New isolation carts were ordered hospital wide

with drawers big enough to hold extra supplies and

are used for multiple patient use.

Effect

Having enough PPE equipment stocked in the hallways resulted in staff members saving time looking

for equipment elsewhere. This also resulted in increased compliance with isolation protocols and patient

safety.

Name(s) Department Supervisor Date

Meghan Davilo 2med/peds Diane McGrath 11/16/13

www.HCKaizen.comKaizen Event

Key Performance Indicators

Balanced Scorecard

• Are we working to improve on all

aspects of the organization?

• People

• Service

•Quality

• Finance

•Growth

Daily Huddles

• 5-10 minute stand-up

meetings by

metrics/kaizen board

• Structured with

standard agenda

• Capture problems &

suggestions, not solve

them

Leadership Walk

• Leaders spending time in the workplace

• Ensure standard work is being followed and

observe for new opportunities for

continuous improvement

• Engage with employees to learn

about their work day

• React to problems in a positive

manner

Visual Management

•Meant to expose problems and

reduce information deficits

• Should reduce questions that come

up repeatedly

Make things visual

Kanban = signal

• Inventory management using

visual cues

•Replenishment signals should be

labeled with: item name, number

to restock, when to restock, and

the location of more

Kanban System

Lab Storeroom

5S Workplace Organization

• Sort = dispose of clutter

• Straighten = organize by use

• Shine = light cleaning

• Standardize = label workspace

• Sustain = audit to ensure organization

is being maintained

• Safety should underlay all 5

5S and Visual Management

Why Lean?

Improved QualityCost Reductions

Without Layoffs

Error Prevention Improved

Patient Safety

Reduced Waste

Increased

Employee Engagement

Lean can mean improved:• Delivery of care for patients

• Patient satisfaction

• Staff satisfaction

• Consistency in the way work is completed

• Standard process for information flow

• Capacity

• Financial performance

• Employee engagement

Get Involved!Beyond general Lean and Kaizen activities happening at the

department level Riverside has Lean projects working on larger

cross-department workflows and organizational strategic goals.

Current and Past Lean Projects Include:

• Miller admission process

• Discharge by 1PM

• Process of admitting an ED

patient to a nursing unit

• Behavioral health intake process

• Senior life patient transportation

• Management of broken/extra

beds

Where

do we

start?

If you have any questions or

would like to learn more

about Lean at Riverside, feel

free to contact me:Sara Meyer

Lean Educator

smeyer@rhc.net

(815)935-7256 x6392