Lean Healthcare: Project Deployment and Sustainability

1. Lean Healthcare Deployment and Sustainability Chapter 17 - Project David Murtaugh Certified Six Sigma Green Belt Industrial Engineering and Engineering Management Student at Mercer University

2. What is a Project? • One of the three types of actions that a transformation team identifies in a rapid improvement plan. The other two are Just Do Its and rapid improvement events. • Definition: An improvement effort often conducted by an engineer or small team to determine the best approach for achieving a desired outcome. ETM 528 Murtaugh Lean Healthcare Ch. 17 - Project

3. Example Improvement Projects • Six Sigma Projects • Visual Management • Mistake Proofing • Kanban System • Setup Reduction ETM 528 Murtaugh Lean Healthcare Ch. 17 - Project

4. What is Six Sigma? • Statistical concept that refers to the amount of variation in a process. • Magic number: 3.4 defects per million opportunities or less • Also refers to a continual improvement methodology to reduce defects and decrease variation ETM 528 Murtaugh Lean Healthcare Ch. 17 - Project

5. What is Lean Sigma? • Lean differs from Six Sigma in that it focuses on increasing process throughput by eliminating waste. • Targets mainly the “lower-hanging fruit” • More intuitive and less analytically based than Six Sigma ETM 528 Murtaugh Lean Healthcare Ch. 17 - Project

6. DMAIC (Dr. Burtner’s Favorite) http://www.sixsigmadaily.com/what-is-dmaic/ ETM 528 Murtaugh Lean Healthcare Ch. 17 - Project

7. What is Visual Management? • A set of techniques designed to improve the workplace organization and standardization (Uh oh one of those 5S things) • Anyone entering the workplace, even those unfamiliar, should be able to quickly and easily see what is supposed to be happening and what is under control and what is not. • Also referred to as 5S ETM 528 Murtaugh Lean Healthcare Ch. 17 - Project

8. 5S http://www.kaizenworld.com/what-is-5s.html ETM 528 Murtaugh Lean Healthcare Ch. 17 - Project

9. What Does 5S Do? • Provides a foundation for a disciplined and reliable approach to the workplace • Stimulates excitement and commitment toward additional improvement efforts • Benefits include • Improved patient care • Reduced cost of care • A cleaner clinical area • Reduction in non-value-added time • Safer working conditions ETM 528 Murtaugh Lean Healthcare Ch. 17 - Project

10. How to Implement 5S • Get everyone in the workspace involved • Have leaders set expectations and conduct follow-up • Agree on a vision • Define roles • Start with a cross-functional team • Agree on and establish standards • Establish routines and checklists • Keep it simple stupid ETM 528 Murtaugh Lean Healthcare Ch. 17 - Project

11. What is Mistake Proofing? • In this case it is a little different from just stretching before a kickball game (@Ben) • Definition: Using process or design features to prevent errors or the negative impact of errors • Also known as poka-yoke which those of you fluent in Japanese know means “avoiding inadvertent errors” • Two types: Prevention and Detection ETM 528 Murtaugh Lean Healthcare Ch. 17 - Project

12. Examples of Poka-Yokes • Bathroom Sinks • Vehicles (Lots) • Ethernet Cables • Sharps Container http://www.tidalwavega.com/blog/ ETM 528 Murtaugh Lean Healthcare Ch. 17 - Project https://en.wikipedia.org/wiki/Sharps_container

13. What is a Kanban System? • A method of using cards or other signaling devices as visual signals for triggering or controlling the flow of materials and supplies • Two basic types of kanban signals • Production kanban – paces the flow of product through the value stream pathway • Withdrawal kanban – indicates the need to resupply materials consumed • Tied closely to Just-In-Time (JIT) principles ETM 528 Murtaugh Lean Healthcare Ch. 17 - Project

14. Considerations of a Kanban System • Processes should be standardized and stabilized before implementation • Ensure quality prior to movement • Produce or move nothing without kanban • Consumers “pull” from the supplier • Suppliers should produce only to the kanban limit ETM 528 Murtaugh Lean Healthcare Ch. 17 - Project

15. What is Setup Reduction • A method of analyzing a process to reduce the materials, skilled resources, and time required for setup or turnover • Setup time is defined as the time required to do ALL activities to change over from the end of one activity to the start of another activity ETM 528 Murtaugh Lean Healthcare Ch. 17 - Project

16. Performing Setup Reduction Analysis • Six, I repeat Six, Steps People (6 steps) • Document the current state • Separate external and internal work • Classify setup steps • Modify • Implement Ideas • Continue to improve ETM 528 Murtaugh Lean Healthcare Ch. 17 - Project

17. GLOSSARY Project (page 169) An improvement effort that is typically data analytic and is often conducted by an engineer or small team to determine the best approach for achieving a desired outcome. Kanban System (page 179) A method of using cards or other signaling devices as visual signals for triggering or controlling the flow of materials and supplies. Just-in-time (JIT) (page 180) A system in which materials or components are delivered immediately before they are required in order to minimize inventory costs. Setup Reduction (page 182) A method of analyzing a process to reduce the materials, skilled resources, and time required for setup or turnover. ETM 528 Murtaugh Lean Healthcare Ch. 17 - Project

18. References / Contact Information Dean, M.L. (2013). Lean Healthcare Deployment and Sustainability. New York, NY: McGraw Hill. Contact Information: David Murtaugh 10916756@live.Mercer.edu ETM 528 Murtaugh Lean Healthcare Ch. 17 - Project