SMART Wheelchair & Seating Kaizen

November 2008

• To identify areas for process improvement

• To Improve patient experience

• Reduce waiting times

• Improve access

• Improve equipment options

Objectives

• Protected time

• Cross-service representation

• Process mapping pre-event

• Day one - extensive workout

– Identify issues using 3 process maps

– Group into common themes

– Identify potential solutions

– Prioritise solutions

Approach

• Days 2 – 4: ‘try storming’

– ‘5S’ in 4 store areas

– Sort, Set in order, Shine, Standardise, Sustain

• Final Day - Action plan

Action Plan

• 28 actions identified– Admin procedures– Patient pathway– Improved use of ReTIS– Stores

• Many actions completed within the week

• Streamlined referral process:

• Goal: Shorter referral – assessment period

• Issues:

– Incomplete referrals

– Separate referrals for each service

– Adult Wheelchair

– Children’s Wheelchair & Seating

– Adult Seating

– Person dependent

Administration Procedures

Actions

• Referral Group

• Number of different referral forms reduced

• Creation of email address

• Access to SCI Gateway

Results

• SMART Referral form

• Single point of contact

• Reduction in incomplete referrals

• Reduction in printing

Patient Pathway

• Creation of combined adult and children power chair clinic

• Children:– Maximum wait reduced from 11-4 weeks

• Adult:– Maximum wait reduced from 8-5 weeks

• One-stop adult clinic re-established due to

modernisation funding

• Chair storage facilitated through 5S

• Many patients attending clinic are receiving a

chair at clinic

– Adult 42%

– Children 20%

Patient Pathway

Improved Use of ReTIS

• ReTIS ‘wish list’

• Standardisation of ReTIS use across services– Adaptations to ReTIS (new job

types, screen appearances etc)– Staff refresher training

• More joined up working

Improved Use of ReTIS

• Accurate data entry of wheelchair stock:

– Chair locations and status in ReTIS ‘untrustworthy’

– Large data cleansing exercise

– New store locations created in ReTIS

• Reduced stock errors

– Quicker patient provision

Improved Use of ReTIS

• Still ‘to do’ list

• ReTIS to be available at point of

wheelchair receipt (remote store)

– Quicker stock availability

• Provision of networked laptops for

domiciliary visits

– More efficient use of staff time

Stores

• 5S in all SMART stores:

– SMART wheelchair (children’s)

– SMART wheelchair (adult)

– SMART main component store

– Livingston main store

• Removal of obsolete / excess equipment

Before

After

During

After

After

Before

After

Livingston – Main Wheelchair Store

• £15K investment in improvements

Overall Summary

• Improved referral to assessment process

• Combined children and adult power chair

clinic

• Re-establishment of one-stop clinic

• Integrated processes across services

• Enhanced team work

Benefits yet to be realised

• Shorter waiting times with:

– Staff recruitment / training

– Release of modernisation funds

• All SMART staff

• ReTIS team

• Lean In Lothian

team

• NHS Lothian

• Edinburgh CHP