Are you too busy to improve? - - VUmc · PDF fileAre you too busy to improve? ... VSM Value...
Transcript of Are you too busy to improve? - - VUmc · PDF fileAre you too busy to improve? ... VSM Value...
Are you too busy to improve? Lean improvement of Nurse Scheduling in the
Operating Theatre
Presentation PICA center
Kjeld Aij
ICT
ICT
Declining healthcare: value (=Q/€)
ICT
Bron: Amalberti, René, et al. "Five system barriers to achieving ultrasafe health care." Annals of internal medicine 142.9 (2005): 756-764.
Average rate per exposure of catastrophes and associated deaths in
various industries and human activities.
Research Article
A focus on Throughput: Lean Improvement of Nurse Scheduling in the
Operating Theatre
Kjeld Harald Aij, Frederique Elisabeth Simons, Merel Visse & Guy A.M.
Widdershoven
12-03-20 makigami current situation
Reasons for Research
Lean is…
Continuously improving, every day,
by everyone, everywhere,
for the patient
Solution? LEAN
Lean is designed to improve the efficiency of processes by eliminating
unnecessary activities in terms of variation, overload and waste
VSM Value adding activities
Non value adding activities
Makigami:
Type of Value Stream Mapping, especially designed for mapping
processes in complex environments
How to Improve the OR Nurse Scheduling?
Multidisciplinary team of 9 healthcare professionals
Makigami process:
1. Current state
2. Setting the ideal state
3. Fishbone analysis
4. Actions
5. Mapping the revised process
1. Current state
3 sessions: total of 8 hours
Also: daily problems were monitored (direct observations over 7 days,
spread out over 2 months)
2. Setting the ideal state
The right people
At the right time
At the right place
First time right planning
No wastes
Patient safety and employee satisfaction
3. Fishbone analysis: identify root causes
4. Actions
5. Revised process
Discussion
Results indicate that Makigami can assist in optimizing OR
nurse scheduling and help to identify waste and indicate
relevant improvements.
Application of this method was found to reduce outcome errors by
90% and waste in the process by 41%.
The Makigami tool also taught the team members the importance
of a multidisciplinary approach.
Challenges and limitations
Challenges
The demand for information and requirements varied
between the OR nurses in charge of nurse scheduling
It is a challenge to involve the different stakeholders in the
process
OR environment is less standardized than that of an
automobile factory
Limitations
One specific clinical process; problem of representativeness
Processes studied may not be applicable to smaller units
Observations do not have statistical support
Future research
Studies looking at different processes
Examine other OR personnel as well
(anaesthetists and recovery nurses)
Develop quality- and patient-oriented
scheduling solutions that offer new
opportunities for research on system
design for OT scheduling
Conclusion of this study
The Lean method (Makigami) is effective as a means of reducing
waste and for standardizing processes in OR nurse scheduling
Wrap up
Time for questions
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