smoothing the flow: the m25 dr steve kingsbury dr ann york
TRANSCRIPT
Smoothing the Flow: the M25
Dr Steve Kingsbury
Dr Ann York
Topics to be Covered
Demand and capacity definitions Bottlenecks Segmentation and Carve-out Batching and Hand Offs Variability Churn Anticipating Flow
Demand: definition
demand is not a number of referrals it is how much staff time each referral takes to
discharge times the number of referrals e.g. 10 referrals that take 10 hours each are a
demand of 100 hours How much car parking space do we need?
Capacity: definition
again capacity is not a number like 3 staffbut a number of units of time that can be delivered e.g. 3 staff can deliver 3 x 16 clinical hours = 48 hours
How many cars can we park?
Bottlenecks
demand greater than capacity bottlenecks can occur at any step of a process queues form at bottlenecks (Waiting list!)
Segmentation
Fast, medium and slow lanes
Carve-outs
Reserving capacity for a set task e.g. bus lanes inefficient as often under-utilised or constrain
patient flow
Batching
Grouping tasks that is efficient for the task but causes delay for those who were batched first
Traffic lights Those waiting are not happy
Variability
If two or more processes aren't in synch then together they can function very poorly.
Here the two processes are traffic arriving and the traffic lights.
Churn
Over use of priority criteria which moves a section of the demand through the system “churning” leaving the “sediment” behind..
Anticipating Flow
Why are fixed assessment or treatment clinics helpful?
If we wait for capacity………
Compared to anticipating capacity..
Smoothing the Flow
Once all the eddies and turbulence are removed….