Whenever you make the decision to attempt a Lean journey, you will need to start thinking about the magnitude with this change, since it is enormous. Many of your present practices will change to be much more focused on patient care (the reason why you got into healthcare) and much less on the daily aggravations of searching for the things you will need to supply that care. You must have a great framework to gauge the progress of one’s lean efforts. First, as you look at the changes coming, you have to:
Let’s start with defining just what a hospital value stream is: a Value Stream is a collection of interconnected processes to supply value to a customer. A price stream example in a hospital describes the care of a patient that arrived to the hospital via the Emergency Department, was admitted to the Telemetry unit, and was discharged home. Another value stream example describes the flow of patients that can come to the hospital for outpatient surgeries:
Each process advances the care of the patient. The sum total of these processes delivers value to the patient and is what we call a Value Stream. There are numerous value streams in a hospital and each of them must mature returning to perfection, as that is our goal french stream and the target of any Lean initiative. How can we track the progress of the Lean implementation on a certain value stream? We do this by establishing a five-level framework to gauge the progress.
Engagement. By this we mean a advanced level of involvement by the entire staff. Simply improving is not sufficient in a Lean Value Stream. Without the active involvement by everyone in the job of process improvement, it will undoubtedly be difficult to improve fast enough in today’s competitive environment.
Level 1: Identify the Value Stream and assign ownership. The very first logical part of improving a benefit stream is to spot and document it. This maturity level involves naming a benefit stream, assigning a benefit stream owner to it, and creating both current and future state value stream maps. We will even wish to establish performance metrics for the worth stream: Discharge performance, Medication Administration performance, productivity, quality, and so on.
Level 2: Patient Flow and Pull. The largest opportunity when moving from the traditional work place to a Lean environment could be the introduction of flow and pulls methods. Patient wait amount of time in traditional environments can represent around 70% of the full total patient length of stay. In cases when you flow products, like Sterile Processing of Instrument sets, experience has shown that cycle time relates to an extended set of related benefits, including improved productivity, better quality, less floor space, improved flexibility, and higher on-time delivery of the Instrument sets back once again to the OR Suite.
Level 3: Standardization. Once we have harvested the low hanging fruit of flow and pull, we ought to continue with the job of training the certifying the staff in Standard Work. We have to involve the entire staff in defining the one best way to complete work, and to train them to complete the job that way. Remember that standard work does not limit creativity or improvement, but it will determine how a work must certanly be done for today’s time.
Level 4: Engagement. The stage of engagement is what separates the Lean pros from the amateurs, when we are assessing value stream maturity. Until we have the ability to involve the entire workforce in the creative work of continuous improvement, our Lean efforts will continue to be at risk of outside competitors simply copying what we have done. Once we are generating hundreds and tens and thousands of small improvement suggestions per year, it will undoubtedly be very problematic for your competitors to help keep up.
Level 5: Sustained Performance. Until we have the ability to incorporate flow, pull, standard work and employee engagement into our hospital culture, things will inevitably backslide. We can claim that individuals are in Level 5 on the worth stream maturity scale when we have the ability to shown that individuals have maintained continuous improvement for an amount of at least 36 months.
The starting point, obviously, would be to map your primary value streams. As the Value Stream Mapping concept is well-know, in reality few organizations (hospitals or factories) have actually taken that first step. If you’re willing to go forward with your time and effort, get some good expert help from mentoring organizations like Leonardo Group Americas. Getting training and insight from individuals who have done this before many times is very valuable.