lean roadmap part 3+ case studies
DESCRIPTION
While many hospitals today are making an effort to introduce Lean thinking and methods into their organizations, the most important part of Lean is often overlooked: building a culture of continuous improvement. Without this it will be difficult to sustain improvements that are made, and it will be difficult to improve quickly enough to keep up with the challenges that healthcare now faces. Creating a hospital with Kaizen Spirit is not something that is easy, or that happens overnight, but it is achievable through persistence and by following a proven path or roadmap. In the final of a 3-part series, Gerard Leone, co-author of "Roadmap for the Lean Hospital" will address the implementation and sustainment of improvement suggestions. Also, he will share 2-3 real-life case histories of Lean initiatives in the hospital setting and the results that each yielded.TRANSCRIPT
Implementing a Kaizen Suggestion
Systemand
Kaizen Case Histories
• Principal, Leonardo Group Americas LLC.• Co-Author of Fundamentals of Flow Manufacturing,
Aerospace Flow, In the OR series of Lean Hospital books.
• Vice President of Technology, JCIT.• Trained over 5000 manufacturing professionals
seeking improved performance over his tenure at JCIT and CSU.
• Adjunct Instructor of Manufacturing Management at Colorado State University.
• Implementation Leader in over 150 businesses of various sizes.
• Lean Hospital work since 2002.• In charge of the Lean Healthcare practice at LGA.• Bilingual Spanish-English.• 12 years of manufacturing management and
teaching at university level prior to consulting career.
GerardLeone
• Principal, Leonardo Group Americas LLC.• Co-Author of Fundamentals of Flow Manufacturing,
Aerospace Flow, In the OR series of Lean Hospital books.
• VP of Technology, John Costanza Institute of Technology.
• MBA, University of Colorado and APICS CPIM certified.
• Trained over 5,000 Lean professionals since 1994.• Lean Hospital work since 2002.• Creator of the Lean Operations track for the
Aerospace Supplier Excellence Alliance (SEA).• 16 years of manufacturing management at Storage
Technology Corporation and Ball Corporation prior to consulting career.
• Bilingual Spanish-English.
RichardRahn
Webinar Overview
An important element in the creation of a culture of continuous improvement is the engagement of the entire hospital
staff in sharing and implementing improvement suggestions. These ideas
should be easy to think up, easy to approve, and easy to do. The approach is
called “Quick and Easy Kaizen”.
ASSESS O.R.OPERATIONS
ASSESS O.R.OPERATIONS
START LEAN HOSPITAL TRANSFORMATION
START LEAN HOSPITAL TRANSFORMATION
SET UP PERFORMANCE
DASHBOARD
SET UP PERFORMANCE
DASHBOARD
TRAINLEADERSHIP
TEAM
TRAINLEADERSHIP
TEAM
CONDUCTPILOT PROJECTS
CONDUCTPILOT PROJECTS
TRAIN HOSPITAL STAFF
TRAIN HOSPITAL STAFF
IMPLEMENTGOAL DEPLOYMENT
TOOLS
IMPLEMENTGOAL DEPLOYMENT
TOOLS
CONDUCT INITIAL KAIZEN EVENTS
CONDUCT INITIAL KAIZEN EVENTS
IMPLEMENTSUSTAINABILITY
ROADMAP
IMPLEMENTSUSTAINABILITY
ROADMAP
INSTITUTE UNIT CPI TEAM
INSTITUTE UNIT CPI TEAM
KAIZEN MENTORCERTIFICATION
TRAINING
KAIZEN MENTORCERTIFICATION
TRAINING
IMPLEMENT KAIZEN SUGGESTION SYSTEM
IMPLEMENT KAIZEN SUGGESTION SYSTEM
ROADMAP COMPLIANCE AUDIT
ROADMAP COMPLIANCE AUDIT
SUSTAINEDPERFORMANCE
SUSTAINEDPERFORMANCE
The Lean Hospital Master Plan includes a definition of identified
improvements, resources required, implementation
timeline, estimated benefits, and ROI for the selected value streams.
Conduct a comprehensive, lean-focused audit, with the objective of advancing the Lean Culture at the Hospital.
Each team leader presents the status of completed Kaizen projects to ensure results and sustained performance.
Train a team of Hospital Staff to become internal Lean Mentors.
Organize a local Continuous Process Improvement Team to identify, evaluate, and implement improvements.
To support the Hospital’s Lean journey, Leaders must understand the tools and culture of Continuous Process Improvement.
A Lean Hospital embraces a participative model of Continuous Improvement. All Lean Hospital employees must be trained to be a part of this culture. Conduct Value Stream analysis for each
unit and department to identify opportunities for improvement. Create a unit-level Master Plan.
Roll-out unit and department process improvement activities per the Lean Hospital Master Plan.
Formalize the process of soliciting, receiving, evaluating, and implementing process improvement suggestions for the entire hospital.
Select highly visible areas for proof of concept and buy-in. Follow
Kaizen methodology to achieve results in less than 5 days.
KAIZEN MENTORCERTIFICATION
KAIZEN MENTORCERTIFICATION
Certify all Internal Lean Mentors through completion of actual projects and Knowledge Checks.
VALUE STREAM ANALYSIS AND MASTER PLAN
VALUE STREAM ANALYSIS AND MASTER PLAN
DEVELOP UNITMASTER PLANS
DEVELOP UNITMASTER PLANS
Establish lean performance metrics and method for reporting, analysis,
and follow-up.
Lean Hospital Implementation Roadmap
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1415
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2
An initial assessment of current hospital operations, including future vision and level of process improvement maturity. Includes
analysis of potential benefits.
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4
5
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7 8
Train Leadership Team in the principles of Hoshin Kanri (Goal Deployment) and formalize internal process. Use A3-X chart and Team Charter forms for all Master Plans.
COMPLETE A3 PROJECT STATUS
COMPLETE A3 PROJECT STATUS
CONDUCT Q&E KAIZEN
TRAINING
CONDUCT Q&E KAIZEN
TRAINING
START KAIZEN SUGGESTION SYSTEM
START KAIZEN SUGGESTION SYSTEM
LEAN HOSPITAL KAIZEN SUGGESTION SYSTEM
Quick and Easy (Q&E) Kaizen is the soliciting, documenting,
reviewing, approving and implementing small
improvement suggestions by hospital staff. Initial training
will be needed.
SET UP KAIZEN MANAGEMENT
DATABASE
SET UP KAIZEN MANAGEMENT
DATABASE
ENTER SUGGESTIONS FOR IMPROVEMENT
ENTER SUGGESTIONS FOR IMPROVEMENT
REVIEW AND APPROVE KAIZEN
PROJECTS
REVIEW AND APPROVE KAIZEN
PROJECTS
PRIORITIZE SUGGESTIONS
PRIORITIZE SUGGESTIONS
CONDUCT KAIZEN EVENT
CONDUCT KAIZEN EVENT
COMMUNICATE RESULTS TO HOSPITAL
COMMUNICATE RESULTS TO HOSPITAL
COMPLETE KAIZEN EVENT PREPARATION
COMPLETE KAIZEN EVENT PREPARATION
COMPLETE KAIZEN PLANNING
COMPLETE KAIZEN PLANNING
CONDUCT STAFF CPI MEETINGS
CONDUCT STAFF CPI MEETINGS
POST RESULTS OF A3 PROJECT STATUS
POST RESULTS OF A3 PROJECT STATUS
FUNCTIONAL KAIZEN SUGGESTION SYSTEM
FUNCTIONAL KAIZEN SUGGESTION SYSTEM
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Continuous Process Improvement (CPI) meetings are led by a
department manager, and take place at least weekly. Suggestions are captured during this meeting.
An electronic database is needed, with ability to
manage and share data across the hospital system
and submit ideas easily.
Capture suggestions during the Kaizen meetings and enter into KMS. Suggestions will also come from Value Stream Mapping and independent input.
Prioritize ideas according to your hospital’s unit priorities or KPIs.
Use KMS to document detailed tasks, key participants, value
streams affected and expected benefits. Use A3 Team Charter format for a consistent format.
Establish activity date.
Good preparation is a key to success, including coordinating with all staff members, gathering required data
and securing resources.
Conduct the event according to the Kaizen Event Roadmap.
Keep hospital informed on the latest suggestions approved and projects available. Update dashboard and status report. Show results to all employees.
The Kaizen Leader will prepare the final Kaizen
Event summary in A3 Project Status format.
The A3 Project Status Report documents the Pre and Post-Kaizen state with an explanation of the tools applied and the benefits achieved.
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5
PROCESS Q&E SUGGESTIONS
PROCESS Q&E SUGGESTIONS
Review, approve and implement ideas at the unit or department level. In most cases the submitter is also the implementer. Provide feedback within 24 hours.
For non-Q&E suggestions, identify the financial benefits and qualitative benefits. These suggestions will require planning.
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CONDUCT MANAGEMENT
KAIZEN TRAINING
CONDUCT MANAGEMENT
KAIZEN TRAINING
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Kaizen Suggestion System Roadmap
Kaizen RoadmapThe Roadmap: Record,
Review, Execute, Follow-upCase Histories:
ED to Admit Process Hospital Supervisors OR Supplies Management
Next Steps
The Potential Is Huge
Webinar Topics
Phase 5: Recording Suggestions
The Goal Is To Say Yes Levels of Review
Phase 6: The Review Process
Review and Approval is Necessary.
Unintended Consequences.Department Manager, then
Lean Steering Committee.Response Time: 24 hours for
Q&E improvements.Post improvements visually.
Less Effort Needed Levels of Review
Phase 7: Q&E Improvements
Approval by Department Manager.
90%+ of the improvements should be Q&E.
Don’t require ROI analysis.Person suggesting the
improvement will do it. Avoid holding up big projects
as examples.
Simple Prioritization Y-Axis: Level of Difficulty and
Cost (1-10) X-Axis: Level of Benefit (1-10) Once a decision to go ahead is
made, put the Kaizen Event on a calendar.
Another method: Hoshin Kanri A3-X Chart.
Another method: ROI comparison.
Problems Are Jewels
Phase 8: Prioritizing Kaizen Events
Phase 9: Complete Kaizen Planning
Phase 10: Kaizen Preparation
Phase 12/13: The A3 Project Status
Phase 14: Communication Vehicles
Case History 1
ED to Admit Patient Flow
Opportunity for Improvement Benefits Achieved
ED-to-Admit Time
Several months worth of data show that the time to obtain a bed for an admitted patient through the ED was an average of 62 minutes. Furthermore, once the bed was assigned, the time to get the patient to the bed in the admitting unit was 81 min on the average. The total average wait time a for an admitted patient was 143 minutes. This was a great source of frustration for the ED and admitting unit RNs as well as a low point in patient satisfaction surveys.
Case History 2
HospitalSupervisors
Opportunity for Improvement Benefits Achieved
Hospital Supervisors
During a Value Stream Mapping exercise aimed at improving patient flow, it was identified that the whole control over bed placement was in the hands of the Hospital Supervisor. The Hospital Supervisor position at EGSMC was originally devised as the “Air Traffic Controller”. Hospital Supervisors commented on the fact that their main job of bed placement was severely hindered by having to deal with many spurious calls that distracted them from placing admitted patients in beds.
Case History 3
OR Materials
Management
Opportunity for Improvement Benefits Achieved
OR Materials Management
The unpredictable availability of surgical supplies was identified a major source of dissatisfaction among OR personnel and surgeons. Furthermore, the hospital’s senior leadership team indicated that the amount of inventory dollars in the Perioperative Services department was far higher than in most of the benchmarked hospitals. .
Generally Speaking• Embarking on a Kaizen
initiative is no small undertaking.
• Make sure you have a solid infrastructure of commitment, KMS, training, Lean Management System before starting.
• The potential is huge, so get up the learning curve fast.
Kaizen OnDemand• One way or another, you
will need a KMS.• Home-grown solutions may
seem attractive, but will cost you much more.
• Leverage the input from a community of users.
• Request a 1:1 demo or view our April 17th KMS demo (see post-webinar survey)
Next Steps
Questions?
Leonardo GroupPrincipals: Gerard Leone & Richard D Rahn303-494-4404Boulder, Co 80303
PowerHealth OnDemandKeith Snyder l Director of Marketing
720-290-6513Greenwood Village, Co 80111