Lean operations in Health care

Presented By Group 02:

Deepti Prabha 1220150

Soumya Balakrishnan 1220160

Amit Kumar Samal 1220107 Jithin Babu 1220120 Seetharaman Thopa 1220140 Ankush Singh 1220110

Introduction
-Lean thinking begins with driving out waste so that all work adds value and serves the customer's needs -Identifying value-added and non-value-added steps in every process is the beginning Requirement

An organizational culture that is receptive to lean thinking

All staff should be involved in helping to redesign processes to

improve flow and reduce waste

Similarities between Health care and Manufacturing

Workers must rely on multiple, complex processes to accomplish their tasks Provide value to the customer or patient

Waste of money, time, supplies, or

goodwill decreases value When applied rigorously it demonstrates a positive impact on productivity, cost, quality, and timely delivery of services.

Lean Health care

Most cost efficient care

Eliminating waste

Work sampling
Reducing excessive inventories

Applications of Lean in Healthcare

Laboratories

Reducing Turn Around Times and Errors

Reducing diversions, improving flow Reducing patient delays, increasing capacity Reducing changeover times, increasing utilization Reducing errors, improving response Reducing wasted food, improving quality

Emergency Departments

Outpatient Cancer Treatment

Operating Rooms

Pharmacies

Food Service

What is Waste in Healthcare?

Transportation

Moving same patient, specimens, or supplies, workers.

Motion

Searching for patients, needed meds, right charts, supplies.

Waiting for bed assignments or discharge, or testing results Processing

Retesting ,More paperwork ,Duplicate procedures.

Inventory

Linen (laundry) ,Pharmacy stock ,Supplies Specimens waiting for analysis

Defects

Label on the wrong tube, Wrong procedure ,Wrong patient ,Missing information.

MUDA Approach

This process eliminate the waste in the process.

These tools helped decrease movement of patients and supplies that did not add value

It eliminated idle time created when materials, information, people or equipment were not ready.

It allowed staff to eliminate the redundancy of

supplies, materials, and instruments.

Spaghetti Diagram
Use of

Computer Edit checks,

Pictorial Instructions, Signals,

Sensors,
Counters Checklists to re-design the service, administrative processes maps

to develop systems that provides: What the Patent wants, Using the Method the Patient wants/needs, When a Patient wants/needs it.

Typical Example of Seattle Childrens Hospital.

Applying Kanban system like tubing. Using C.P.I., the hospital has reduced the waiting time. Using C.P.I., the hospital has eradicated the problem of

lack of space in recovery rooms.

Results:

The cost per patient actually fell by 3.7 percent after its implementation.

more patients are taken care off, thus reducing the

number of potential deaths.

Lab Benefits from Lean

Productivity improvement >30% Space savings of >450 sq ft Standardized work practices Reduction in Errors and Error Potential Test Turnaround Time (CT) reduced by 50%

5S in Healthcare
5S is a workplace organizational tool that creates an environment that allows work to flow, in safe, organized, intuitive and sustainable way.
Sort : Separate what is
unnecessary

Shine : Clean it up Set In Order : Organize Standardize : Establish

standard operating procedures

Sustain : Develop long-lasting

habits

Proven 5S Lean Solutions

From a single Supply Drawer Organization Project..

Tourniquets on Dispenser Rolls

Tube Rack

Drawer Organizer Bins

LabWall Panel

Organizer Bins

Tilt Bins

Side-Loading Glove Dispenser

To a Standard Benchtop Workspace

Specimen Bag Dispenser

Workstation Risers

Group Technology
One Worker, Multiple Machines
Machine 2 Machine 3 Machine 1

Materials in

Finished goods out Machine 4

Machine 5

Virginia Mason Medical Centre (application of lean management)

Using lean management principles since 2002 To eliminate waste, Virginia Mason created more capacity in existing programs and practices so that planned expansions were scrapped, saving significant capital

expenses.

Participated in Rapid Process Improvement Weeks(RPIW) in which teams analyze processes and propose, test, and

implement improvements.

By making use of RPIW Virginia Mason imporved their productivity.

Results of Virginia Mason after implementation RPIW

CATEGORY 2004 METRIC RESULTS AFTER LEAN $1,350,000 158 22,324 23,082 Travelled 267,793 Travelled 272,262 7,744
Dollars

CHANGE FROM 2002

Down 53%

INVENTORY PRODUCTIVITY FLOOR SPACE LEAD TIME PEOPLE DISTANCE PRODUCT DISTANCE SET UP TIME

FTEs Sq. Ft. Hours Feet Feet Hours

36% redeployed Down 41% Down 65% Down 44% Down 72% Down 82%

The Virginia Mason Medical Centre Strategic Plan

Meadows Regional Medical Centre

issues with bottlenecking, turnaround times, decreased satisfaction

and overworked nurses.

conducted a three-day lean overview workshop 44 action items for reducing the time needed to admit, treat and discharge non-critical ER patients

Changes made by the hospital included standardizing mobile supply stations; labeling racks, trays and drawers; installing a color-coded

flag

system

outside

patient

rooms;

issuing

patients

red allergy armbands to alert medical staff; and adding a holding area for patients who need to see a doctor but who don't need a

room.

Imlemented IT Reduced patients waiting time, reduced

turnaround times.

room employees are now more empowered to take initiative and make changes that could positively impact their work process a hallmark of the lean system.

References

Graban, Mark; 2009, Lean Hospitals, Improving quality, patient safety, and employee satisfaction. CRC Press, London p75 Liker.JK & Meier DP; 2007,Toyota Talent. Developing your people the Toyota Way, McGraw-Hill, New York http://www.leanblog.org/

THANK YOU