annual lean journey begins with keys to kaizen & a path ......lean journey begins with keys to...

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Lean Journey Begins with Keys to Kaizen & a Path to Prefab

October 17th, 2019

Victoria Navarro, Advocate Aurora Health

Dave Mikos, Anderson Mikos Architects

Josh Odelson, Power Construction

Chris TenEyck, Connelly Electric

O V E R C O M I N G O U R I N D U S T R Y C H A L L E N G E S W I T H L E A N S O L U T I O N S

2 1 ST AN N U A L

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Speakers

• Victoria Navarro

– Regional Director of Planning, Design

& Construction at Advocate Aurora Health

• Josh Odelson

– Senior Project Manager at Power Construction

• Dave Mikos AIA, ACHA

– Chairman & CEO of Anderson Mikos Architects, ltd.

• Chris TenEyck

– Senior Project Manager at Connelly Electric

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Learning Objectives

In this session you will learn about ….

• What is a 3P Kaizen Event?

• Why is this Process Valuable to the Customer?

• How to Implement 3P Kaizen and Develop a Path to Prefab?

• Keys to Success

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Advocate Aurora Health – Lean Journey

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What is Kaizen? Change for Good and Continuous Improvement

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3P – Production Preparation Process

• A rapid cycle Lean process that focuses on generating

lots of ideas; with simultaneous input from all stake

holders up front for the layout of the Procedural Center

Why 3P Kaizen?

• Speed to market - 6 months shorter design schedule

• Operational efficiency through process improvement

• Supports elimination of waste through lean thinking

What is 3P?

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Typical 3P Kaizen Team Members

• Executive Sponsor

• Project Champions

• Nurses

• Physicians

• Clinical Support Staff

• Support Services Leaders

• Architects

• Design Engineers

• Construction Team

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3P Kaizen Schedule Overview

DAY 3DAY 2DAY 1

3P Training

GembaWalk/ Observe & Analyze Current Process

Listen to the VOCs

Design / Evaluate

Evaluate 7 Flows

Decide Best “Parts”

Create Hybrid Design

Final Flows

Final Presentation

Kick-offMeeting

Team Exercise

Value Stream Mapping

M44-6 hours

Visioning Kaizen Event

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Voice Of the Customer (VOC) just ask!

What works well in the current state?

What does not work well?

How would your customer design the future

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Design Process

• Using current layout

• Design multiple ideas to improve flow

• Remember to minimize movements

• Prepare layouts for presentation and voting----QUICKLY

• Flow of patients

• Flow of clinicians

• Flow of medications

• Flow of supplies

• Flow of equipment

• Flow of information

• Flow of process

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Moonshine Design

• 4 Design Concepts Produced

• (6 Design Concepts thrown under the table)

• Voted on 4 Concepts Down to Top 2

• “Moonshine” down to One Design

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The Seven Flows “Its all about FLOW”

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After Three Days of 3P……

Kaizen Day 3 Under Construction

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3P Kaizen Preliminary Results

• Future Metrics – TBD

• Patient Satisfaction

• Associate Satisfaction

• Operation Workflow (Footsteps)

18%6

Months$4M

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Prefab/ Modular Project Vision

Precast Panels

Multi-Trade Racks Prep/Recovery

Pods

Modular Surgical

Ceilings

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Modular: Prep/ Recovery Pods

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Modular: Surgical Ceiling Systems

Stick-Built Vendor A Vendor B

Prefab Typical OR Ceiling System

Material n/a $ 59,344 $ 84,675

Installation - Mechanical n/a $ 6,000 $ 6,000

Installation - Electrical n/a $ 2,500 $ 2,500

Supplementary Steel for OR Ceiling System n/a $ 15,000 $ 15,000

Stick Built Typical OR Ceiling System

HVAC - Supply ductwork and grilles $ 33,000 n/a n/a

Power/Lighting $ 22,500 n/a n/a

Ceiling Grid $ 12,000 n/a n/a

Med Gas System $ 5,000 n/a n/a

Drafting/Coordination (mech) $ 6,300 n/a n/a

Drafting/Coordination (elec) $ - n/a n/a

Supplementary Steel for boom supports $ 8,000 n/a n/a

86,800$ 82,844$ 108,175$

Cost Delta (3,956.00)$

OR Surgical Ceiling System Evaluation

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Prefab: OR Walls

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Prefab: Multi-trade Racks

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Prefab: Multi-trade Racks

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Modular/ Prefab: Metric Tracking

Preliminary Metrics (Based On First Production Runs)

• Multi-trade Racks

• MEP Overhead Install (150 linear feet) – Typical: 20 days

• MEP Overhead Install (150 linear feet) – Racks: 5 days

• 50%+ Reduction in MEP Deck Inserts

• Plumbing – First Run used 82% of typical labor

• HVAC & Medgas – First Run used 80% of typical labor

• Electrical – First Run used 60% of typical labor

• Pods – Electrical Rough-Ins – First Run saw 30% labor reduction

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Prefab/ Modular Project Vision

Prefab OR Walls

Multi-trade RacksPrep/Recovery

Pods

Modular Surgical

CeilingsPrecast Panels

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Prefab/ Modular Project Vision

Proposal Presentation Under Construction

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Keys to Success• Respect for People

• Build Trust Among the Team (The ENTIRE Team)

• Educate entire Owner’s team on value of 3P Kaizen

• Document Future State Operational Processes During Kaizen

• Establish leader for each Prefab/ Modular Line

• Multi-trade Racks – Start modeling them Day 2

• Have FUN!!!

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Contact Us

25

Josh Odelson

Power Construction

jodelson@powerconstruction.net

Victoria Navarro

Advocate Aurora Health

victoria.navarro@aah.org

Chris TenEyck

Connelly Electric

christ@connellyelectric.com

Dave Mikos

Anderson Mikos Architects

dmikos@andersonmikos.com

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In the spirit of continuous improvement, we would like to remind you to

complete this session’s survey in the Congress app! We look forward to

receiving your feedback. Highest rated presenters will be recognized.

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Prefab: What Does the Future Hold?• WE NEED TO ACTUALLY DO IT!!!

• Prefab MEP Racks get delivered for install on 10/28/19

• Prep/ Recovery Pods get delivered for install on 12/6/19

• OR Walls get delivered for install on 12/13/19

• Cleansuite OR Ceiling Systems get delivered on 12/30/19