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WHAT OUR CLIENTS SAY... |
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» "I’m so impressed with this Lean process… after 8 years of different programs; it’s exciting to see this work…"
» "I’m excited to work with the new more efficient flow…”
» "The RPI process is amazing! It helps to have fresh eyes evaluate the area and come up with solutions….”
» “There should be amazing gains in the billing process. The teamwork that was developed during the RPI was remarkable and should pay dividends for years to come.”
» “The result of this standard work process should help the organization in time savings, tighter control on resources and collaboration.”
WORKSHOP CASE STUDIES
SUCCESS STORIES
JWA Clients Publish Success Stories
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With more than a decade of experience of lean implementation in healthcare, we have come to understand that the keys to success lie not in a set of lean methods and tools but in the systems that drive improvement. We refer to the “system” as the Lean Healthcare System.
Achieving the Lean Healthcare System is a long term journey. We call the first 4-5 years of work the “Foundational Years." The goal of the Foundational Years is to ensure that client organizations reach the “tipping point” of Lean Healthcare System implementation as shown below. The partnership between JWA and executive leadership ensures the development of internal lean expertise so our clients continue to achieve results for years after we leave their organization.
Achieving the Lean Healthcare System is a long term journey. We call the first 4-5 years of work the “Foundational Years.” The goal of the Foundational Years is to ensure that client organizations reach the “tipping point” of Lean Healthcare System implementation as shown below. The partnership between JWA and executive leadership ensures the development of internal lean expertise so our clients continue to achieve results for years after we leave their organization.
Getting to the “tipping point” requires:
- Learning the tools, methods and technical content of the Lean Healthcare System
- Transforming the culture
- Implementing lean management systems that sustain gains and drive continuous improvement
Systems, structures and processes used to do the above:
- Lean Resource Office (LRO) implementation
- Breakthrough planning tied to strategic plan
- Daily management to sustain gains
- Restructuring to support value streams
- Linkage with HR systems
- Lean Fellow and Lean Leader certification
- Replication strategies and methods
- Standard improvement methods including Rapid Process Improvement (RPI), 5S, Rapid Process Design (RPD), Model Line improvement, Value Stream Mapping and Alignment, FMEA, Root Cause Problem Solving
- Measurement systems
JWA’s Lean Healthcare System measures results on behalf of patients and families in five categories. Figure 3 is key to understanding that lean is not simply another “management cost reduction strategy” but a balanced approach of simultaneous improvement in quality, cost, delivery, safety and engagement, referred to as QCDSE.
Key Outcomes During Foundation Years
Year |
Theme |
Key Outcomes |
1 |
Establish Foundation |
- Common understanding
- Infrastructure established
- Point improvements
- Identify & select initial value streams
- May choose to focus on non-clinical areas
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2 |
Connect the dots |
- Value stream improvement (generally non-clinical)
- Lean leaders “certified” to drive the work
- Fully functioning LRO
- Lean priorities are tied to annual goals and strategic plans
- Clinician education and involvement begins to grow
- Tier 2 Clinical value streams in the queue
- Management system beginning to take shape
- Daily management system in place to sustain gains and choose additional
priorities
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3 |
Begin to see value stream results |
- Continued Value Stream Improvements
- Restructure staff support around value streams
- Attack structural barriers
- Realize that after you have improved an area it becomes easier to identify
more waste!
- Lean Leader knowledge and alignment either a catalyst for or limiting
factor in success
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4 |
Enterprise Focus |
- Replicate and extend value stream work
- Include key suppliers and customers
- Advanced education demands
- Begin to see competitive advantage
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There are a variety of lean tools and methods employed by the Lean Healthcare System, following is an introduction to some of them.
Certification programs are available.
Rapid Process Improvement (RPI) Workshops
RPI’s are a 5 day workshop focused in a targeted area. During the week, representatives from the area are asked to assess the current process, envision the process without waste, and conduct projects to implement the vision during the week. The goal of an RPI is to achieve 50% improvement during the week of the event. RPI participants are trained in all aspects of the Lean Healthcare System and immediately begin applying what they have learned to their own work area.
During an RPI, participants are taught key elements of the Lean Healthcare System including:
• Waste
• Standard Work
• Quality and Mistake Proofing
• Rapid Changeover
• Continuous Flow
• Pull Systems
• Work Balance
• Managing Change
5S Workshops
The 5S’s are Sort, Simplify, Sweep, Standardize and Sustain. During a 3 day 5S event, participants implement all 5S’s to achieve workplace organization and standardization. The outcomes include reduced search time, improved safety, improved ergonomics, space and inventory reductions.
Value Stream Mapping and Alignment
A Value Stream Map is a visual representation of the activities required to produce healthcare from the perspective of the patient. The map, at a minimum, includes the flow of patients, material and information. Value Stream Alignment sessions produce a consensus of the “future state” of the Value Stream and the plan for achieving the future state. Value stream work is most effectively used when tied directly to an organization’s strategic plan.
Daily Management System (DMS)
A Daily Management System ensures that the gains achieved in lean events are held and that continuous improvement becomes a way of everyday managing. Prerequisites for Daily Management include standard work and customer focused metrics. This system defines standard work for supervisors, managers and executive leadership as they work on daily improvement.
Rapid Process Design (RPD)
Used to design new processes or dramatically redesign existing processes, this 5 day begins with education and ends with new process layout or flow. The RPD kicks off a series of projects rather than incorporating implementation into the workshop week (as in RPI).
3P for Facility Design (see RPD/3P NICU to the left for example)
A variation of the RPD is an adaptation of manufacturing’s “production preparation process," or “3P” workshop. Clinicians, operations staff and managers, architects, contractors and lean experts collaborate on achieving facility design to optimize the seven healthcare flows: staff, patients, medications, information, equipment, supplies and families. Multiple 3P events are required for large projects.
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