Transcript Value Stream Management for Lean Healthcare

Value Stream Management for
Lean Healthcare
ISE 491
Fall 2009
The Elimination of Waste in
Healthcare - Lecture 5
Eight Categories of Waste (in Healthcare)
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Overproduction
Waiting
Excess Motion
Excess Conveyance
Over-processing
Inventory
Defects
Unused Creativity
Fall 2009
ISE 491 Dr. Burtner
Lecture 5 Slide 2
Overproduction (Unnecessary Services)
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Producing work or providing a service before it is
required or requested
Some Elimination Strategies
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Establish continuous work flow in terms of product or
service needed at the appropriate time (for the downstream
customer)
Create visual controls to prevent early processing of
information or services
Ensure information is only entered into one common
database for authorized users
Create checklists to ensure all necessary information is
collected at the appropriate time
Ensure email distribution lists and reports are distributed to
necessary staff only
Fall 2009
ISE 491 Dr. Burtner
Lecture 5 Slide 3
Waiting
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Waiting for people, equipment, signatures, supplies,
information, etc.
Some Elimination Strategies
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Review and standardize signature and approval
requirements.
Cross-train staff to accommodate changes in service
demands
Balance workloads throughout the day and ensure staff
members are working optimally.
Ensure equipment and supplies are located in close
proximity to their required use.
Ensure work items are labeled and a point-of-use (as
appropriate)
Fall 2009
ISE 491 Dr. Burtner
Lecture 5 Slide 4
Excess Motion
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Excess movement of people, equipment, paperwork,
electronic communication that does not add value
Some Elimination Strategies
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Ensure supply areas are well organized utilizing color codes
and labels for quick access
Organize computer files for easy retrieval
Establish file naming conventions within departments
Establish standards of communication ensuring doctor’s
orders and charts are easily accessible for authorized staff.
Relocate staff, equipment, to closest area that requires
service
Fall 2009
ISE 491 Dr. Burtner
Lecture 5 Slide 5
Excessive Conveyance (Excessive Transportation)
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Delivering work products without adding value
In the healthcare environment, the patient is a “work
product” that flows through the system
Examples
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Delivery of equipment too early or too late
Transporting patients to surgery prematurely
Moving samples or specimens to the wrong location
“Placing a gurney in the hall and constantly having to more
it”
Fall 2009
ISE 491 Dr. Burtner
Lecture 5 Slide 6
Overprocessing
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Putting work into accomplishing something that the
patient, physician, or healthcare provider either does
not ask for or does not want
Results in non-value added work that the customer
does not want to pay for
Examples
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Retesting (eg. Performing a second 24-hour urine test
because a staff member obtained the first specimen
incorrectly)
Ordering more diagnostic tests than the diagnosis warrants
(eg. ordering a Chem 24 when a Chem 6 will suffice
Entering repetitive form information
Completing excessive paperwork
Fall 2009
ISE 491 Dr. Burtner
Lecture 5 Slide 7
Inventory
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Excess or outdated supplies; excess work piles
Elimination of inventory frees up space and makes it
easier to find essential items quickly
Examples
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Duplicate medications and supplies in excess of normal
usage
Obsolete office equipment
Excessive office supplies
Obsolete charts, files, and medical equipment
Extra or outdated manuals, newsletters, or magazines
Fall 2009
ISE 491 Dr. Burtner
Lecture 5 Slide 8
Defects
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Also known as mistakes or errors
Defect waste includes all processing required to
correct a defect or mistake
It takes less time to do it right the first time than to
discover and correct the mistakes
Examples
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Medication errors
Incorrect patient information
Incorrect procedure
Missing information
Redraws
Fall 2009
ISE 491 Dr. Burtner
Lecture 5 Slide 9
Unused Creativity
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Not utilizing the available talents and skills of the
staff to their fullest
Examples
 Insufficient cross-training of staff
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Reluctance to elicit process improvement ideas
from workers closest to the process
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Design of policies, procedures, and practices
without sufficient input from workers
Fall 2009
ISE 491 Dr. Burtner
Lecture 5 Slide 10
Primary Sources
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The Lean Healthcare Pocket Guide XL
(2008) Authors: Debra Hadfield, RN MSN
and Shelagh Holmes, RN
Value Stream Management for Lean
Healthcare (2009) Authors: Don Tapping,
Sue Kozlowski (CSSBB), Laura Archbold
(RN, BSN,MBA), and Todd Sperl (MBB)
Fall 2009
ISE 491 Dr. Burtner
Lecture 5 Slide 11