Lean Healthcare

1

• Lean Healthcare

Presented by Melanie Sudduth Director of Lean
Healthcare South Carolina msudduth_at_scmep.org 864-3
54-4773
2
Why Are We Here Today?

• Provide a brief introduction to SCMEP
• Provide an overview of Lean Healthcare
• Spotlighting
• - Lean An Overview of the Tools
• - reVIEW Program
• - TWI

3
Who is SCMEP

• An independent, non-profit 501c3 organization
  with its own charter and board of directors made
  up of SC manufacturing company owners and senior
  executives, as well as representatives from the
  state technical college system, research
  universities and Department of Commerce.
• Mission - To Strengthen the Global
  Competitiveness of South Carolina Businesses
• Vision - To be a primary resource for the South
  Carolina business community in providing
  highly-valued technological, workforce, and
  business solutions that improve competitiveness

4
Services for Business

• Executive Leadership Services (Strategic
  Planning, MA, Business Valuations, Succession
  Planning Exit Strategies, etc.)
• Top Line Growth (Marketing, Sales, Eureka Winning
  Ways and Lean Product Development)
• Productivity/Process Improvements (Lean, TOC,
  Engineering Design, etc.)
• Quality System Implementation (6 Sigma, ISO, QS/
  TS Automotive, AS Aerospace standards)
• ISO 14001, Energy Assessments
• Environmental, Health Safety Assistance
• Human Resource Solutions

5
SCMEP Impacts for 2008

• Companies Served 1,823
• Investment 36.3 MM
• New and Retained Sales 152 MM
• Cost Savings 49.9 MM
• Jobs Created/Retained 1,360
• Overall Economic Impact 254.8 MM

6
Defining Lean

• Lean is
• A systematic approach to identifying and
  eliminating waste (non-value added activities)
  through continuous improvement by flowing the
  product or service at the pull of the customer in
  pursuit of perfection.
• The MEP Lean Network

7
Definition of Value-Added

• Value-Added
• Any activity that increases the market form or
  function of the product or service. (These are
  things the customer is willing to pay for.)

• Non-Value-Added
• Any activity that does not add market form or
  function or is not necessary. (These activities
  should be eliminated, simplified, reduced, or
  integrated.)

8
Lean Eliminating NVA
Value-Added

• Non-Value-Added (Muda)
• Overproduction
• Waiting
• Confusion
• Processing
• Inventory
• Defects
• Motion/Travel

Typically gt60 of the total lead time is
non-value-added.
9
Overproduction

• Producing more than is required by the next
  process
• Producing earlier than is required by the next
  process
• Producing faster than is required by the next
  process
• Examples of overproduction
• Duplicate charting
• Multiple forms with the same information
• Copies of reports sent automatically

10
Inventory Waste

• Any supply or purchase in excess of the current
  demand
• Examples of excess inventory
• Overstocked medications on units
• Purchasing excess because the piece price is
  cheaper
• Stocking too much at point of use (large cabinet
  fill it up!)
• Disorganization cant find it, so we buy more

11
Defects/Errors

• Inspection and correction of mistakes
• Examples of Defects/Errors
• Wrong dosage/wrong medication administered
• Rework of any kind
• Inconclusive tests
• Incorrect charges/billing
• Surgical errors

12
Processing Waste

• Effort that adds no value from the
  patient/customers perspective
• Examples of processing waste
• True requirements not clearly defined
  Clarifying orders
• Extra copies or excessive information
• Missing medications
• Regulatory paperwork

13
Waiting Waste

• Idle time created when people, information,
  equipment or materials are not at hand.
• Examples of waiting waste
• Waiting on test results
• Waiting on doctor/nurse, etc.
• Waiting on availability of equipment or treatment
  rooms
• Waiting on cleaning of rooms
• Waiting for now medications
• Waiting on supplies

14
Confusion

• People doing the work are confused or not sure
  about what should be done.
• Examples of confusion
• Unclear MD orders
• Unclear route for medicine administration
• Unclear system for indicating charges for billing
• Same activities being performed different ways
  different people

15
Motion/Travel Waste

• Any movement of people, equipment, supplies, etc.
  that does not add value.
• Examples of motion waste
• Looking for information, supplies, people, etc.
• Supplies not located at point of use
• Unfavorable layout
• Supplies not prepped prior to patient treatment

16
Lean Building Blocks
Continuous Improvement
Cellular/Flow
Pull/Kanban
TPM
Quick Changeover
Quality at Source
POUS
Standardized Work
Batch Reduction
Teams
Value Stream Mapping
5S System
Visual
Facility Layout
17
Standardized Work

• All work is safely conducted with all tasks
  organized in the best known sequence, and using
  the most effective combination of these
  resources
• People
• Materials
• Methods
• Equipment

18
5S Workplace Organization Standardization
5S Sort Set in Order Shine Standardiz
e Sustain
A safe, clean, neat arrangement of the workplace
provides a specific location for everything, and
eliminates anything not required.
19
Visual Controls

• Simple signals that provide an immediate
  understanding of a situation or condition. They
  are efficient, self-regulating, and
  worker-managed.
• Examples
• Kanban cards
• Color-coded forms, supplies, etc.
• Lines on the floor to direct visitors to correct
  departments
• Lines on the floor to instruct staff where to
  return carts, equipment, gurneys, etc.
• Andon lights outside patient rooms (signals)

20
Facility Layout
21
Teams

• Teams Cross-trained and multi-skilled personnel
• Teams for Continuous Improvement
• Process quality, not inspection
• Decision-making done by those doing the work
• Problem solving teams

22
Setup or Changeover Reduction

• Definition The time required from the completion
  of the last procedure until the start of the next
  procedure. Set-up includes getting instruments,
  getting supplies, setting-up rooms, getting
  materials, and getting paperwork.
• Benefits include
• Improvement of capacity and volume
• Increase in flexibility
• Increase in competitiveness
• Increase in Patient Satisfaction
• Increase in Physician Satisfaction

23
Impact of Batch Size Reduction
Batch and Queue Processing
Process C
Process A
Process B
10 min.
10 min.
10 min.
30 min. for total order, 21 min. for first piece
Continuous Flow Processing
Process B
Process A
Process C
12 min. for total order, 3 min. for first part
24
Point Of Use Storage (POUS)

• Materials, Supplies and Equipment is where used
• Benefits
• Reduced Motion/Travel
• Decreases patient delays
• Increases patient throughput
• Reduces confusion and searching

25
Quality at the Source

• Personnel must be certain that work is being
  performed correctly
• Techniques used
• Samples or visual standards
• Process documentation defining quality
  requirements
• Poka Yoke Mistake Proofing Techniques
• Root Cause Analysis Tools (A3 Problem Solving)

26
Push versus Pull Systems

• In a pull system of service, the timely
  transition of work from one step in the process
  to another is the primary responsibility of the
  downstream (i.e., subsequent) process

27
Cellular Flow

• Linking of processes into the most efficient
  combination to maximize value-added content while
  minimizing waste.

28
Total Productive Maintenance (TPM)

• Systematic approach to the elimination of the six
  major equipment losses
• Setup and adjustment
• Breakdowns
• Idling and minor stoppages
• Reduced speed
• Startup
• Defects and rework

29
Conclusion

• Lean
• Simple and visual
• Patient driven
• Supplies as needed
• Reduce non-value-added
• Minimal lead time
• Quality Controls
• Value stream managers

• Traditional
• Complex
• Internally driven
• Excessive supplies
• Speed up value-added work
• Long lead time
• Rework Errors
• Functional departments

30
Thank You.