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OAHHS LEAN WEBINAR SEPTEMBER 16TH,2014

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Welcome: Thank you for Joining!

• Define and Measure Overview and Examples (15 min)

– Anthony Veasey, Purdue Healthcare Advisors

• Samaritan Health Services Lean Project (10 min)

– Sheri Johnson, Samaritan Health Services

• Q & A (5 min)

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• Define & Measure Key Components

• Define and Measure Lean Tools

• Define & Measure Lean Case Examples

• Questions ?

Overview of this Section

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“Define & Measure Key Components”

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“Lean is a set of tools in a toolbox, Proficiency comes with experience” …

• Your skill with lean tools improves over time and with continued practical application

• PHA is here to support you with questions on lean tools and practical application

• Lean Templates are available on our website http://training.tap.purdue.edu/ • Download templates to computer portal access

ends 1 year post final day of training

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Date: Project Title and Area: Organization:

Authors:

Def

ine

Mea

sure

Imp

rove

C

on

tro

l

Pre

-

Set Goal – “SMART”

Define the problem

Understanding the waste & variation

Preventing recurrence of the waste and variation

Select Project

Removing the waste & variation

An

alyz

e

Tools

Quantifying the waste & variation

Hoshin Kanri VOCS VSM

Team Selection Exec sponsor Process owner

Project Y Project charter SIPOCS VOCS (SWOT; Affinity; CTS; Kano) Communication Plan

Gantt Chart

Data collection plan Gemba Analysis Process flow charts Spaghetti diagrams Scatter plots

Pie charts; Bar graphs Control Charts Pareto Takt time; cycle time

Tools

Tools

Define Lean Tools

Define Lean Tools

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Lean Case Examples of Define & Measure Phase

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Lean ED Throughput Case Example of Define & Measure Phase

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Define: Project Charter (Problem Statement)

The Hospital’s Patient Flow problem negatively impacts the quality of patient care, increases exposure to risk, and decreases financial profitability. Patients wait and are treated in hallways, which increases the potential for medical errors. In addition, patients are not receiving the appropriate level of care in the ED, post physician disposition, specifically patients that are to be admitted to the ICU and Telemetry. Clinical staff must be reallocated to monitor patients being housed in the ED overflow holding areas, which impacts other clinical location’s staffing effectiveness.

Team Sponsor- COO/CMO

Why Is

This A

Problem ?

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Define: Business Case Business Case Currently 85% of admissions to come through the Emergency Department. Over the past few years, patient flow inefficiencies and bottlenecks have been a

consistent and intractable problem. Long delays are a patient safety issue and are a priority to the organization. Inefficiencies and delays limit patient access and taxes limit human financial

resources. Employee turnover costs the organization in recruitment cost, and employee dissatisfaction impacts worker productivity and quality of work life. Patients who leave due to long wait times are missed revenue opportunities. Licensure and accreditation bodies mandate improvements in patient flow and organizational focus on patient flow processes. Wait times are delays of an ongoing problem without abatement. Peak season is upon us (November –March). Surge issues related to emergency/mass casualty plans and Disaster preparedness

are impacted by patient flow issues.

Why Is

This A

Problem ?

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Suppliers Inputs Process Outputs

ED/Patient Flow SIPOC

Customers Requirements (CTS)

•Physician Offices •EMS •Patients •N.H •Prisons •Other Facilities (Inpt/Psy)

•MD/Nurse Staff/Skill •Ancillary Procedure/Tests •Diagnostic Equipment •Support Staff/Skills •Service Skills

•Appropriate DX&TX •Appropriate Disposition •Satisfied Patients

•Patients •Physicians/Offices •Community •NH/Prisons

•Informed about delays •Waiting Time to see MD •Adequate of Info family friends •Staff Care about me as a person •Management of pain

Patient Arrival

Triage Registration Start

Treatment Diagnosis Treatment

Disposition Admit Bed

Assigned MD

Orders

Patient Sent

To Floor

Discharge

Define: Scoping the

Problem ?

Variation in format

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Define: ED VSM Visual representation of process is shown

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Define: ED Waste DOWNTIME

ED Waste

Hospital Specific Example