When you make your choice to embark on a Lean journey, you will need to start thinking about the magnitude with this change, because it is enormous. A lot of your present practices will change to be more centered on patient care (the reason why you got into healthcare) and not as on the daily aggravations of searching for all the things you will need to provide that care. You must have a good framework to gauge the progress of one’s lean efforts. First, as you think about the changes coming, you must:
Let’s begin by defining exactly what a hospital value stream is: a Value Stream is an accumulation of interconnected processes to provide value to a customer. A value stream example in a hospital describes the care of someone that arrived to a healthcare facility via the Emergency Department, was admitted to the Telemetry unit, and was discharged home. Another value stream example describes the flow of patients which come to a healthcare facility 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 on its way to perfection, as that is our goal and the target of any Lean initiative. How do 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 isn’t sufficient in a Lean Value Stream. Minus the active involvement by everyone in the task of process improvement, it will undoubtedly be difficult to boost fast enough in today’s competitive environment.
Level 1: Identify the Value Stream and assign ownership. The initial logical part of improving a benefit stream is to identify 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 desire 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 a traditional work environment to a Lean environment could be the introduction of flow and french streaming complet pulls methods. Patient wait amount of time in traditional environments can represent up to 70% of the full total patient period of stay. In cases where you flow products, like Sterile Processing of Instrument sets, experience shows that cycle time is related to a lengthy listing of related benefits, including improved productivity, better quality, less floor space, improved flexibility, and higher on-time delivery of the Instrument sets back to the OR Suite.
Level 3: Standardization. Once we’ve harvested the low hanging fruit of flow and pull, we must continue with the task of training the certifying the staff in Standard Work. We need to involve the entire staff in defining the main one easiest way to complete work, and to coach them to complete the work that way. Remember that standard work doesn’t limit creativity or improvement, but it will determine what sort of work should be prepared for the current time.
Level 4: Engagement. The stage of engagement is what separates the Lean pros from the amateurs, once 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 remain vulnerable to outside competitors simply copying what we’ve done. Once we’re generating hundreds and a large number of small improvement suggestions a year, it will undoubtedly be very problematic for your competitors to 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 could claim that individuals are at Level 5 on the worth stream maturity scale when we have the ability to shown that individuals have maintained continuous improvement for a period of at the very least 36 months.
The kick off point, obviously, is to map your primary value streams. Whilst the Value Stream Mapping concept is well-know, the truth is few organizations (hospitals or factories) have actually taken that first step. If you’re willing to move forward with the time and effort, get some expert help from mentoring organizations like Leonardo Group Americas. Getting training and insight from people who have done this before often times is extremely valuable.