When you make the decision to embark on a Lean journey, you need to start thinking about the magnitude of the change, as it is enormous. A lot of your present practices will change to be much more centered on patient care (the reason why you found myself in healthcare) and much less on the daily aggravations of searching for the things you need to deliver that care. You need to have a great framework to measure the progress of your lean efforts. First, as you look at the changes coming, you should:
Let’s start with defining just what a hospital value stream is: a Value Stream is an accumulation interconnected processes to deliver value to a customer. A benefit stream example in a hospital describes the care of a patient 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 that can come to a healthcare facility for outpatient surgeries:
Each process advances the care of the patient. The sum total of the processes delivers value to the patient and is what we call a Value Stream. There are many value streams in a hospital and each of them must mature returning to perfection, as that’s 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 accomplish that by establishing a five-level framework to gauge the progress.
Engagement. By this we mean a high 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 task of process improvement, it is going to be difficult to boost 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 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 the traditional work environment to a Lean environment could be the introduction of flow and pulls methods. Patient wait amount of time in traditional environments can represent up to 70% of the total patient period of stay. In cases where you flow products, like Sterile Processing of Instrument sets, experience shows that cycle time relates to an extended list of related benefits, including improved productivity, better quality, less space on the floor, improved flexibility, and higher on-time delivery of the Instrument sets back to the OR Suite.
Level 3: Standardization. Once we have 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 must involve the entire staff in defining the main one easiest way to accomplish work, and to teach them to accomplish the task that way. Understand that standard work doesn’t limit creativity or improvement, but it does determine the way the work must certanly be done for the present 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 remain susceptible to outside competitors simply copying what we have done. Once we’re generating hundreds and 1000s of small improvement suggestions a year, it is going to 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, french-stream 4k things will inevitably backslide. We are able to claim that people are in 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 least 36 months.
The starting place, obviously, is always to map most of your value streams. While 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, acquire some expert help from mentoring organizations like Leonardo Group Americas. Getting training and insight from individuals who have done this before often is extremely valuable.
