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Introduction into Lean

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Introduction into Lean and the Every Patient Matters Transformation Programme Section A * Lisa * Section A Lisa Triangle one traditional approach to leadership ... – PowerPoint PPT presentation

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Title: Introduction into Lean


1
Introduction into Lean
  • and the Every Patient Matters Transformation
    Programme

2
Introductions/Objectives
  • Introduce yourself
  • Why have you come along today?

3
Objectives
  • Explain what Lean is
  • Describe the aims of the Every Patient Matters
    Transformation Programme
  • Be able to apply at least one Lean technique in
    your workplace

4
Introduction into..
5
Why do we need Transformation?
  • Fire-fighting has become the norm
  • Patients are pushed through the system no flow
  • Stressed out staff
  • Outdated processes

6
Previous Change Initiatives
RUH 2010
Productive Leader (on-going)
Orthopaedic Lean Project
Productive Operative Theatre (TPOT)
Productive Ward
7
Improving Quality
  • Quality, Innovation, Productivity and Prevention
  • What are the programme objectives?
  • Perception is that its all about efficiency
    savings
  • Every Patient Matters falls under the QIPP
    umbrella and reports to PMO (programme management
    office)

8
QIPP Projects
  • Acute Oncology
  • Ambulatory Care
  • Emergency Surgery Pathway
  • Theatre Scheduling
  • Outpatients
  • And many more
  • Quality and the impact on patient experience is
    the most important factor to consider when
    scoping a project

9
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10
Vision for Transformation
  • To deliver the best possible care to every
    patient involving all staff in
  • developing a culture of
  • continuous improvement

11
What is Lean?
  • What do you think the term Lean implies?
  • Lean is not an acronym, it is a collection of
    tools that assist in the identification and
    elimination of waste (e.g. queues, duplication,
    re-work, waits and delays) and focuses on the
    customer/patient

12
History of Lean
  • Lean thinking, developed from the Toyota
    Production System, has been applied in many
    competitive sectors.
  • It is about changing a business from the roots
    up working to a set of principles to produce a
    culture of continuous improvement that will drive
    sustainable results.

13
Industry Examples of Lean
14
Why use Lean?
  • Such thinking is increasingly being applied to
    health services in the UK and overseas to
  • improve the quality of patient care
  • improve safety
  • eliminate delays
  • reduce length of stay
  • while using no more resources

15
5 Principles of Lean
1. Value Specify value, this must be defined by
the customer/patient. Otherwise known as Voice of
the Customer 2. Value Stream Identify the value
stream/patient journey and the processes that
define it. 3. Flow Align healthcare processes to
facilitate the smooth flow of patients and
information 4. Pull Deliver care on demand with
the resources needed for it. 5. Perfection
Develop and amend processes continuously.
16
Value Stream Mapping
  • Used to identify the processes involved in the
    value stream and which elements had value to the
    customer
  • Different from process mapping in that you
    identify value added and non value added steps
    for the customer and quantify time.

17
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18
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19
Lean Principles Exercise
  • Exercise 1
  • In groups look at the value stream in front of
    you and complete the questions in the exercise
    sheet

20
5s a simple tool to start with
  • 5s is a good first lean technique to use back in
    your work area
  • Sort
  • Standardise
  • Set in Order
  • Sweep and Shine
  • Sustain

21
Before and After pictures
22
5s Principles
  • Engage others in your workplace with the 5s
  • Start small with your own desk!
  • Take photos before and after

23
Waste
  • Waste is anything other than the minimum amount
    of equipment, space, staff time, which are
    essential to add value to the product or service.
  • In Lean 7 types of wastes have been identified,
    there may be more that you can think of

24
7 Types of Lean Waste
25
Waste Exercise
  • Exercise 2
  • In pairs, spend 15 minutes thinking of NHS
    examples for each of the 7 wastes

26
Waste Walk
  • Walking the process from beginning to end (or
    end to beginning)
  • Walking each step, watching what actually happens
    (as opposed to what you are told that happens or
    what is contained in a process flow chart or
    procedure)
  • Talking to the people who undertake each task to
    establish how it happens (and does it happen this
    way each and every time?)
  • Observing for wasteful activities
  • Developing a shopping list of measures (data)
    required that will inform the investigation
  • Photographs anything and everything that appears
    relevant (do you require permission?)

27
  • Best possible care through lean thinking is not
    a project, it is a fundamental change to the way
    in which the hospital delivers its services to
    patients

28
Lean Awareness
200 RUH staff
29
Lean Leadership
30
Culture and Climate
  • Change in an organisation calls for leaders to
    recognise and balance culture and climate
    dimensions.
  • Culture can be divides into five components
    values, beliefs, myths, tradition and norms.
  • Climate is the label used to describe the
    dimensions of the work environment E.g.
    organisation structure, leadership style,
    communication, historical forces.

31
Culture and Climate Exercise
  • Do we have a climate and culture that encourages
    change?
  • Exercise 3
  • Group 1 - Describe the current Culture and
    Climate of this organisation
  • Group 2 - Describe what the Culture and Climate
    of this organisation needs to be.

32
What do our leaders think?
  • Link to chief exec conference culture question
  • http//webserver.ruh-bath.swest.nhs.uk/everypatien
    tmatters/Lean/leadership/index.asp?menu_id5

33
Factors to achieve desired culture and climate
  • 1. Clear Vision
  • 2. Set of values in alignment with the vision
  • 3. Accountability for both performance and
    behaviours with consequences when standards
    arent met.
  • 4. High performing teams that work independently
    and put the needs of the organisation before
    personal needs.
  • 5. Value added communication
  • 6. Rewards/Recognition

34
Next Steps
  • Get your colleagues involved in a 5s activity
  • Think of a problem that you think you could apply
    some lean principles too
  • Book yourself onto the two day change agent
    training
  • Discuss location for waste walk

35
Lean Change Agent Training
  • Two day change agent training follows this half
    day and includes
  • Exercises and group work to demonstrate lean
    principles
  • Waste Walk in your department
  • Process mapping value added, non value added
  • Human dimensions of change
  • Handbook provided with Lean toolkit incl.
    Transformation Approach
  • Please complete feedback sheets be honest as
    you like!

36
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