If you make the decision to embark on a Lean journey, you need to start thinking about the magnitude with this change, as it is enormous. Many of your present practices will change to are more focused on patient care (the reasons why you got into healthcare) and not as on the daily aggravations of searching for all the things you need to provide that care. You need to have a solid framework to gauge the progress of one’s lean efforts. First, as you think about the changes coming, you should:
Let’s begin by defining what a hospital value stream is: a Value Stream is an accumulation interconnected processes to provide value to a customer. A value 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 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. french stream HD 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 particular value stream? We do this by establishing a five-level framework to measure the progress.
Engagement. By this we mean a higher level of involvement by the whole staff. Simply improving is not sufficient in a Lean Value Stream. Minus the active involvement by everyone in the task of process improvement, it will undoubtedly be difficult to enhance fast enough in today’s competitive environment.
Level 1: Identify the Value Stream and assign ownership. The very first logical step in improving a value stream is to spot and document it. This maturity level involves naming a value stream, assigning a value 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 is the introduction of flow and pulls methods. Patient wait amount of time in traditional environments can represent around 70% of the sum total patient period of stay. In cases when you flow products, like Sterile Processing of Instrument sets, experience indicates that cycle time relates to an extended listing of related benefits, including improved productivity, higher quality, less space on the floor, improved flexibility, and higher on-time delivery of the Instrument sets back once again to the OR Suite.
Level 3: Standardization. Once we’ve harvested the reduced hanging fruit of flow and pull, we should continue with the task of training the certifying the staff in Standard Work. We have to involve the whole staff in defining the one best way to complete work, and to train them to complete the work that way. Remember that standard work does not limit creativity or improvement, but it does determine how a work ought to 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 whole workforce in the creative work of continuous improvement, our Lean efforts will remain at risk of outside competitors simply copying what we’ve done. Once we’re generating hundreds and a large number of small improvement suggestions per year, it will undoubtedly be very burdensome for the competition 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 people have reached Level 5 on the worth stream maturity scale if we have the ability to shown that people have maintained continuous improvement for a period of at the very least 36 months.
The starting point, obviously, is always to map most of your value streams. While 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 go forward with your time and effort, get some good expert help from mentoring organizations like Leonardo Group Americas. Getting training and insight from those who have done this before many times is quite valuable.