Académique Documents
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Culture Documents
Continuous Improvement
Lean in Healthcare
What is Lean?
Definition-The endless
A little History
The 4P model
Problem
Solving
(Continuous
Improvement
And
Learning)
Process
(Eliminate Waste)
Philosophy
(Long-Term Thinking)
45-75%
Cost Reduced
25-55%
Throughput/Flow Increased
60-90%
50-90%
Inventory Reduced
60-90%
Space Reduced
35-50%
50-90%
LEAN
Interdisciplinary teams
Managers direct
Benchmark to justify not
improving; just as good
Managers teach/enable
Seek the ultimate
performance, the absence
of waste
Root cause analysis
Rewards: group sharing
Supplier is ally
Share information
Removing waste lowers cost
Customer focus
Process driven
Blame people
Rewards: individual
Supplier is enemy
Guard Information
Volume lowers cost
Internal focus
Expert driven
Examples of process
improvement tools
A3 reporting
STRAIGHTEN
SUSTAIN
SHINE
STANDARDIZE
Eliminating Waste
Overproduction
Pills given out
early
Treatments done
to balance staff
Duplication of test
Eliminating Waste
Transportation
Moving same
patient,
specimens, or
supplies,
workers
Eliminating Waste
Motion
Searching
for
patients,
needed meds,
right charts,
supplies
Eliminating Waste
Waiting
for bed
assignments
or
discharge,
or
testing results
Eliminating Waste
Processing
Retesting
More paperwork
Duplicate procedures
Eliminating Waste
Inventory
Linen (laundry)
Pharmacy stock
Supplies
Specimens waiting for
analysis
Eliminating Waste
Defects
Medication error
Wrong procedure
Wrong patient
Missing information
Management Principles
to LEAN Development Process
14
Mission Statement
Develop the ability:
To recognize and identify waste
To have the courage to call it waste
To have the desire to eliminate it
Eliminate the waste
Understand that waste simply
Raises costs
Produces no corresponding benefit
Threatens all of our jobs
STREAMS
Office visit
Inpatient stay
Visit to the ED
Characteristics:
Technology curiosity
Common sense
Inner confidence
(create structure, Win allegiance, instinctive
reactions)
Cross Functional Team:
Manager/Supervisor from the area
Operators from area
Functional departments
(HR, Lab, Pharmacy, Admitting, Surgery,
Materials Management,etc.)
RESOURCE MATRIX
NAME TITLE SKILL SKILL SKILL SKILL
1
2
3
4
Larry
Moe
Curly
Initiate Team
Training:
Read required literature
Attend team and leadership training, lean
overview
Tools:
Standardized analysis and simulation tools
Video cameras, TVs, and VCRs
Computers, Printer, and Projector
Facilities:
Lean War Room located in the operational area
Office area appropriately furnished and supplied
Baseline Analysis
1.
2.
3.
Process Charts
Process:
Subject:
Beginning:
Ending:
Step
no.
Time
(min)
Distance
(ft)
1
2
3
4
5
0.50
10.0
0.75
3.00
0.75
15
40
40
6
7
8
9
10
1.00
1.00
4.00
5.00
2.00
60
200
11
12
13
14
15
3.00
2.00
3.00
2.00
1.00
4.00
2.00
4.00
1.00
200
60
180
20
16
17
18
19
Summary
Activity
Operation
Transport
Inspect
Delay
Store
Number
of steps
5
9
2
3
Time
(min)
Distance
(ft)
23
11
8
8
815
Step description
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Check out
Walk to pharmacy
Pick up prescription
Leave the building
Process sequence
Pre- Post data collection
Identify number of possibilities and
combinations
Identify commonality within each
product family
Plan analysis phase
A3 reporting
Line/Cell vision
Product flow
Operator activity
Flexibility
Zero defect production
Group Technology
One Worker, Multiple Machines
Machine
2
Machine
3
Machine
1
Materials in
Finished
goods out
Machine
5
Machine
4
Activity of Operator
Point to Point
Design Considerations
Performance Measurements
Output rates
Floor space
Inventory
Labor