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© 2012 Operational Performance Solutions, Inc.
Operational Performance Solutions, Inc. 77 East Main Street, Suite 402 Westminster, Maryland 21157
www.OPSgroupinc.com
August 22, 2012
Implementing Lean in
Healthcare Organizations:
“Roadmap for Success”
Presented by
John Beakes, Jr.
President and CEO, OPS, Inc.
© 2012 Operational Performance Solutions, Inc. 2
John Beakes, Jr. Background
Co-founder with John Beakes, III of OPS. Serving as President and CEO. Has led the development of the OPS Lean Healthcare Practice.
Co-founder, President, and leader of the Lean practice at RWD Technologies. Lean clients included Ford, Jaguar, Chrysler, and other Fortune 100 companies.
Annapolis graduate; served on nuclear submarines.
© 2012 Operational Performance Solutions, Inc. 3
OPS Webinar Series
April 11, 2012. Art Smalley. Advanced Issues in A3 Problem Solving
June 20, 2012. Russ Scaffede. Enterprise-wide Lean Implementation
These webinars are available for no charge at:
http://www.opsgroupinc.com/lean-process-improvement/webinars/
© 2012 Operational Performance Solutions, Inc. 4
Session Objectives
Learn how to develop:
A roadmap for successfully implementing Lean in your organization
Your organization’s Lean System Model
Review Lean System Models that have been key to successful implementation
Obtain practical lessons learned from successful Lean projects
© 2012 Operational Performance Solutions, Inc. 5
© 2012 Operational Performance Solutions, Inc. 6
Transformation Has Two Elements Technical and Cultural
Technical Tools and Techniques
Pursuit of Perfection
Value Stream Thinking
Disconnected Process Improvement
Tools Deployment
Leadership and Culture
Learning Organization
Advanced Teambuilding
Employee
Empowerment
Employee Engagement
Operational Excellence
Th
e P
ath
to
Le
an
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Quality “True North”
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Quality “True North”
© 2012 Operational Performance Solutions, Inc. 11
Denver Health and Quality
University Health System Consortium ranked Denver Health as one of the top 10 academic medical centers in the U.S. for key inpatient quality indicators 30-Day All Cause Readmission Rate was 8.7%
(ranking #7). Length of stay index, which compares observed
to expected length of stay, was 0.89 (ranking #8). Mortality index (observed to expected mortality
rate) was the best in the nation at 0.50.
Ref: Imperatives for Quality Report, July 2010 – June 2011.
Denver Health is NOT an OPS client. This data is from the 2011 Denver Health Annual Report.
© 2012 Operational Performance Solutions, Inc. 12
Denver Health Results from
Lean, 2006-2011
12
Denver Health is NOT an OPS client. This data is from the 2011 Denver Health Annual Report.
© 2012 Operational Performance Solutions, Inc. 13
Lean Deployment Guide
© 2012 Operational Performance Solutions, Inc. 14
Healthcare People “Get” Lean
Healthcare is the diagnosis and treatment of illness
Lean is the diagnosis and treatment of process imperfections
The goal is to give healthcare professionals a new way to look at their processes using a small Lean toolset
© 2012 Operational Performance Solutions, Inc. 15
Lean has About 160 Tools
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Healthcare Needs About 11
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Lean Tools for Healthcare
Waste Identification and Elimination Value Stream Analysis Process (VSAP) Standard Work Waste Walk/Spaghetti Diagram Quality Assurance/Mistake Proofing 5S/Visual Management One-Piece Flow (Continuous Flow)/Just-in-Time (JIT) Pull Systems Quick Changeover PDCA/A3 Problem Solving (Root Cause Analysis) Cascading Annual Planning Process
17
© 2012 Operational Performance Solutions, Inc. 18
Highest Quality - Lowest Cost - Shortest Lead Time - Best Safety - Highest Morale
Business Results
Toyota Production System
Just-In-Time Right part, right amount,
right time
• One-Item-Flow
• Takt Time
• Pull Systems
Zero Defects Make Problems Visible
• No defect passed
forward
• Stop and Fix
• Scientific Method
Leveled Schedule – Standard Work – 5S/Visualization
Stability
People Respect for the individual
• Integration of Continuous
Improvement with daily work
• Decisions made at lowest level
• Scientific Thinking
• Every person a problem solver
• Nothing is permanent
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Ref: Going Lean In Healthcare. Institute for Healthcare Improvement. 2005
© 2012 Operational Performance Solutions, Inc. 21
A Medical Center Management System Model
Medical Center
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Benefits of a System Model
Provides an integrating framework
Clarifies system interactions
Facilitates communications
Embodies “the story”
Promotes consistency of purpose
Enhances new employee training
© 2012 Operational Performance Solutions, Inc. 24
Benefits of a System Model
Provides an integrating framework
Clarifies system interactions
Facilitates communications
Embodies “the story”
Promotes consistency of purpose
Enhances new employee training
KEY TO SUSTAINMENT
© 2012 Operational Performance Solutions, Inc. 25
Questions?
© 2012 Operational Performance Solutions, Inc. 26
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Quality “True North”
© 2012 Operational Performance Solutions, Inc. 28
Leadership Commitment and Support Go See Ask Why Show Respect
- Culture Centered on Patient Care - Servant Leadership (EPIC) - Employee Engagement - Cascading Annual Planning Process
The Lean System of Patient Care
Quality “True North”
Principles Patient Centered
Quality at the Source
Standard Processes
Engaged Employees
Pursuit of Perfection
Supplier Partnerships
Objectives Defect Free
Without Waste
Just-in-Time
Continuous Flow
Continuous Improvement
Standard Work
5S/Visual Management Continuous Flow
Mistake Proofing
PDCA
Pull Systems
© Copyright 2008-2012. Operational Performance Solutions, Inc.
© 2012 Operational Performance Solutions, Inc. 29 © 2012 Operational Performance Solutions, Inc. 29
© 2012 Operational Performance Solutions, Inc. 30
Leadership Commitment and Support Go See Ask Why Show Respect
- Culture Centered on Patient Care - Servant Leadership (EPIC) - Employee Engagement - Cascading Annual Planning Process
The Lean System of Patient Care
Quality “True North”
Principles Patient Centered
Quality at the Source
Standard Processes
Engaged Employees
Pursuit of Perfection
Supplier Partnerships
Objectives Defect Free
Without Waste
Just-in-Time
Continuous Flow
Continuous Improvement
Standard Work
5S/Visual Management Continuous Flow
Mistake Proofing
PDCA
Pull Systems
© Copyright 2008-2012. Operational Performance Solutions, Inc.
© 2012 Operational Performance Solutions, Inc. 31
Leadership Commitment and Support
© 2012 Operational Performance Solutions, Inc. 32
Leadership Commitment and Support Go See Ask Why Show Respect
© 2012 Operational Performance Solutions, Inc. 33
Leadership Commitment and Support Go See Ask Why Show Respect
• Culture Centered on Patient Care • Servant Leadership (EPIC) • Employee Engagement • Cascading Annual Planning Process
© 2012 Operational Performance Solutions, Inc. 34
Principles
• Patient Centered
© 2012 Operational Performance Solutions, Inc. 35
ED
Pharm
acy
LAB
Radio
logy
Imagin
g
Hosp
ital
Flo
or
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Performance Review; Professional Recognition; Promotions
© 2012 Operational Performance Solutions, Inc. 36
ED
Pharm
acy
LAB
Radio
logy
Imagin
g
Hosp
ital
Flo
or
36
Performance Review; Professional Recognition; Promotions
Patient
© 2012 Operational Performance Solutions, Inc. 37
ED
Pharm
acy
LAB
Radio
logy
Imagin
g
Hosp
ital
Flo
or
W W W W W W= WASTE
37
Performance Review; Professional Recognition; Promotions
Patient
© 2012 Operational Performance Solutions, Inc. 38
Value Stream Analysis Process
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Principles • Patient Centered • Quality at the Source • Standard Processes
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Standard Work Chart
40
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Lead Checklist
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Principles • Patient Centered • Quality at the Source • Standard Processes • Engaged Employees
© 2012 Operational Performance Solutions, Inc. 43
Medication Sorting
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Medication Sorting
<----- Before
After ----->
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Principles • Patient Centered • Quality at the Source • Standard Processes • Engaged Employees • Pursuit of Perfection • Supplier Partnerships
© 2012 Operational Performance Solutions, Inc. 47
Leadership Commitment and Support Go See Ask Why Show Respect
- Culture Centered on Patient Care - Servant Leadership (EPIC)
- Employee Engagement - Cascading Annual Planning Process
The Lean System of Patient Care
Quality “True North”
Principles Patient Centered
Quality at the Source
Standard Processes
Engaged Employees
Pursuit of Perfection
Supplier Partnerships
Objectives Defect Free
Without Waste
Just-in-Time
Continuous Flow
Continuous Improvement
Standard Work
5S/Visual Management Continuous Flow
Mistake Proofing
PDCA
Pull Systems
© Copyright 2008-2012. Operational Performance Solutions, Inc.
© 2012 Operational Performance Solutions, Inc. 48
Objectives • Defect Free • Without Waste
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Current Rounds made by a Floor RN
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Roaming Supply Cart
Frequently needed supplies are stored in drawers.
Dietary items (i.e. spoons, applesauce, straws, thickener) are located in drawers separate from the linens.
© 2012 Operational Performance Solutions, Inc. 51
Objectives • Defect Free • Without Waste • Just-in-Time • Continuous Flow
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Continuous Flow
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Continuous Flow Before After
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Objectives • Defect Free • Without Waste • Just-in-Time • Continuous Flow • Continuous Improvement
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Continuous Improvement
• Lower the water level • Find rocks • Remove them • Lower the water level • Find new rocks • Remove them • Lower the water level • Etc., etc… • Seek perfection
(a never-ending process)
© 2012 Operational Performance Solutions, Inc. 56
© 2012 Operational Performance Solutions, Inc. 57
Leadership Commitment and Support Go See Ask Why Show Respect
- Culture Centered on Patient Care - Servant Leadership (EPIC) - Employee Engagement - Cascading Annual Planning Process
The Lean System of Patient Care
Quality “True North”
Principles Patient Centered
Quality at the Source
Standard Processes
Engaged Employees
Pursuit of Perfection
Supplier Partnerships
Objectives Defect Free
Without Waste
Just-in-Time
Continuous Flow
Continuous Improvement
Standard Work
5S/Visual Management Continuous Flow
Mistake Proofing
PDCA
Pull Systems
© Copyright 2008-2012. Operational Performance Solutions, Inc.
© 2012 Operational Performance Solutions, Inc. 58
The Key Processes for Lean Healthcare
A3 Problem Solving
Value Stream Analysis Process
© 2012 Operational Performance Solutions, Inc. 59
Leadership Commitment and Support Go See Ask Why Show Respect
- Culture Centered on Patient Care - Servant Leadership (EPIC) - Employee Engagement - Cascading Annual Planning Process
The Lean System of Patient Care
Quality “True North”
Principles Patient Centered
Quality at the Source
Standard Processes
Engaged Employees
Pursuit of Perfection
Supplier Partnerships
Objectives Defect Free
Without Waste
Just-in-Time
Continuous Flow
Continuous Improvement
Standard Work
5S/Visual Management Continuous Flow
Mistake Proofing
PDCA
Pull Systems
© Copyright 2008-2012. Operational Performance Solutions, Inc.
© 2012 Operational Performance Solutions, Inc. 60
Building a True Lean Culture
Means winning “one heart and soul at a time”
Each individual comes to a full commitment at their own individual pace
Be patient - some who embrace it slowly become the strongest advocates
You know you’re there when all employees are engaged in identifying and eliminating waste every day
© 2012 Operational Performance Solutions, Inc. 61 © 2012 Operational Performance Solutions, Inc.
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Quality “True North”
© 2012 Operational Performance Solutions, Inc. 64 © 2012 Operational Performance Solutions, Inc.
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© 2012 Operational Performance Solutions, Inc. 66
Leadership Commitment and Support Go See Ask Why Show Respect
- Culture Centered on Patient Care - Servant Leadership (EPIC) - Employee Engagement - Cascading Annual Planning Process
The Lean System of Patient Care
Quality “True North”
Principles Patient Centered
Quality at the Source
Standard Processes
Engaged Employees
Pursuit of Perfection
Supplier Partnerships
Objectives Defect Free
Without Waste
Just-in-Time
Continuous Flow
Continuous Improvement
Standard Work
5S/Visual Management Continuous Flow
Mistake Proofing
PDCA
Pull Systems
© Copyright 2008-2012. Operational Performance Solutions, Inc.
© 2012 Operational Performance Solutions, Inc. 67
Contact Information
Operational Performance Solutions, Inc.
77 East Main Street, Suite 402
Westminster, MD 21157
(410) 871-0995
info@OPSgroupinc.com
www.OPSgroupinc.com
© 2012 Operational Performance Solutions, Inc. 68
Questions?
© 2012 Operational Performance Solutions, Inc. 69
What future webinar topics will be most helpful to you?
© 2012 Operational Performance Solutions, Inc. 70
Contact Information
Operational Performance Solutions, Inc.
77 East Main Street, Suite 402
Westminster, MD 21157
(410) 871-0995
info@OPSgroupinc.com
www.OPSgroupinc.com
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