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Get Lean to Stay in the Green Transforming Healthcare using Lean

Get Lean to Stay in the Green Transforming Healthcare using Lean. Andrew L. McCart. “There are four purposes of improvement: easier, better, faster and cheaper. These four goals appear in the order of priority.”. Shigeo Shingo. What is Lean?. What is Lean?. What is Lean?.

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Get Lean to Stay in the Green Transforming Healthcare using Lean

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  1. Get Lean to Stay in the GreenTransforming Healthcare using Lean Andrew L. McCart

  2. “There are four purposes of improvement: easier, better, faster and cheaper. These four goals appear in the order of priority.” Shigeo Shingo

  3. What is Lean?

  4. What is Lean?

  5. What is Lean? A business culture characterized by the endless pursuit of the elimination of waste. An effective methodology for improving patient safety, quality and cost while preventing delays, bridging “silos” and improving employee satisfaction.

  6. “It would be a lot easier if we could stop calling it lean and understand that it’s all about serving others, developing people and solving problems.” Jon Miller CEO Gemba

  7. Lean Success Not found in the tools, it’s the culture! Respect For People

  8. Why Lean? “It provides a way to do more with less-less human effort, less equipment, less time and less space-while coming closer and closer to providing customers with exactly what they want.” James Womack, author “Lean Thinking” 1996

  9. It’s just a manufacturing thing, right?

  10. Healthcare is Different!

  11. Manufacturing’s Ideal World Goods & Services Delivered Error Free Delivered On-time as requested Delivered Efficiently without waste Delivered Safely Healthcare’s

  12. Goals • Patient Safety • Patient Satisfaction • Employee, Staff Satisfaction • Employee Engagement • Low Turnover • Productivity • Space Utilization

  13. Goal “I could try to think differently”

  14. Virginia Mason HospitalSeattle, WA In two years, lowered the number of ventilator-associated pneumonia from 34 cases to only 4 cases using lean driven standardized process in “ventilator bundle”.

  15. ThedaCareAppleton, WI Started lean in 2003 • Reduced by 50% time to complete clinical paperwork on admission. • Reduced time from ER with chest pains to catheterization from 91 min to 37 min. • Reduced patient waiting time for orthopedic surgery from 14 weeks to 31 hours (from first call to surgery).

  16. Allegheny General HospitalPittsburgh, PA Reduced patient deaths related to central-line-associated blood stream infections by 95%.

  17. Denver Health Medical CenterDenver, CO Since started “lean” in 2005, increased revenue due to improvements by $54 million. • Consolidated and rearrange lab workstations improving flow saving $88,000 and decreased turnaround test result times by 25%. • Piloted noncritical patient flow in ER which increased seeing 5-6 patients per hour from 2 patients per hour (still working on the kinks).

  18. Seattle, WA • Improved flow from pickup through processing in eye bank. • Reduced data errors improving first time quality. Improved Transplant Rate

  19. Lean Thinking Principles for Healthcare

  20. No quick fixes No instant success No magic pill No secret steps No magic wand

  21. Patience Cannot be done overnight

  22. Perseverance Fall down seven times, get up eight. - Japanese Proverb

  23. Practice, Practice, Practice

  24. Meaning of Kaizen

  25. Kaizen Focus Waste elimination

  26. Anything that adds cost or time without adding value as defined by the primary customer is waste.

  27. Who is our Primary Customer?

  28. Let our Customers define Value

  29. The 7 Deadly Wastes Transportation Inventory Motion Waiting Overproduction Over-Processing Defects

  30. Waste becomes accepted That’s just the way work is done around here

  31. Challenge We don’t see it as waste!

  32. Total Lead Time Value Added 5% 95% Non-Value Added

  33. Why Kaizen?

  34. Main Purpose Develop people! Practice observing, analyzing and improving

  35. Means to an End…. Improve the process to improve the people

  36. Where to Start? What are we trying to improve and why?

  37. Go to Gemba to Understand

  38. Collect “Real” Data

  39. Map the Flow Customer Focused and Strategic

  40. 7 Flows of Healthcare Flow of Patients Flow of Family Flow of Providers Flow of Medications Flow of Supplies Flow of Equipment Flow of Information

  41. Patient Centered Design around the patient experience

  42. Yuck!

  43. Follow the pathways

  44. Communicate

  45. 5S Sort Set in Order Shine Standardize Sustain Gap Analysis - Space 45

  46. Immediately make problems visible What is the Purpose of 5S?

  47. Western Approach Hear no problem, See no problem, Speak no problem

  48. String Model

  49. Who Are Our Experts? Total Employee Involvement

  50. Completed String Model 50

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