arommell pomh 1.1

LEAN Office ChampionLEAN Projects 2012• Surgery Services

• Long Term Care Supply Process

PROJECT CHARTER Project: Any process that drives patient

movement through the surgery department.

Purpose: To improve the flow of value for the patients of the Paul Oliver Memorial Hospital Surgery/Procedure Department

Targets: Fewer Cancellations, Fewer negative comments about procedure prep, fewer incomplete charts, better alignment of skills to tasks.

The Players

Executive Sponsors: Donna Clarke, Debbie Link, Peter Marinoff

Value Stream Manager: Angie Anderson, R.N.

Team Members: Carolyn Erickson (Cent. Supply) Jamie Gillison (PAS), Karen Mabrey (Cent. Sched.), Carolyn Feltes, RN (Pool)

Project Manager: Amanda Rommell

Project:

The processes that drive patient movement through the surgery department Initiation

Date:

February 16, 2012

Sponsor/ Leadership Panel:

Donna Clarke – Director of Out Patient ServicesDebbie Link – Chief Nursing OfficerPeter Marinoff - COO

Value Stream Manager (Person most directly responsible for the project area):

Angie Anderson, RN

Team Members:

Carolyn Erickson (CS), Jamie Gillison (PAS), Karen Mabrey (C. Sched.), Carolyn Feltes, RN (Pool),

Purpose of Project:

To improve the flow of value for the Paul Oliver Memorial Hospital Surgery/Procedure Department.

Metrics and Targets (What metrics do you anticipate changing after the project, what are your goal numbers?):

* Fewer Cancellations* Fewer negative comments surrounding the Prep process* Less incomplete charts* Better aligned skills with processes

Project Scope (Beginning and end points of the project):

Scheduling of procedure through receipt of patient satisfaction survey.

Parameters (Processes that must be followed, constraints, etc.):

Deliverables (Tangible outputs of the project):

Current Value Stream MapFuture Value Stream MapDemonstrable knowledge of LEAN processes & Tools

Timeline, including target completion date:

Complete current VSM within wk by date 

Updates (How often will leadership be updated?):

Sponsors will be updated weekly through August, 2012 and then monthly through December 2012.

VALUE STREAM MAPPING

In The Board Room Now!!!

We discussed the rules, the types of waste, and our metrics… we were ready to go!

Going to the GEMBA

After we finished the class-room work of defining each step of the Colonoscopy process, it was time to go to where the work is done (The GEMBA) and see how it all fits together. This is also where we collect our data!

Central Scheduling OR Office Central Supply

A Long Term Care Initiative

There was major disconnect in the Ordering of Stock Room Supplies for the LTC

› Staff were requesting supplies to be ordered that were already on order causing a lot of over-ordering

› The stock was running out on the floor causing low par levels

› Things were being stored in multiple places throughout the store room and on the floor.

So what did we do???

5s Work Place Organization

We Sort, Set in order, Shined, Standardize and Sustained…› This included cleaning the supply room and

removing items that didn’t belong› We organized things that were “like” in

order to make finding items easier› We cleaned the floor and ordered new

storage items› We labeled everything!!! We used item

names and numbers, par levels and corresponding order forms.

A S

YS

TEM

FOR

ALL T

O S

HA

RE Now staff can easily identify what products go where, what should be ordered

when it’s gone and how much of each supply we stock!

Visual Management

We also needed a way to let all shifts know when items were ordered and when they would arrive…

IMPROVING THE FLOW

We focused on two areas that had relatively low % complete & accurate› Information complete and correct from registration

There were 4 hand-offs of patient material in the current value stream. We reduced this to just 2 hand-offs with a minor change.

› PAS being able to contact the RN when patient arrives. The current state had the patient checking in at the front

desk, waiting in the lobby, being taken by a RN to another waiting area, and then back to the Recovery Room.

PAS Schedules - Prints Itinerary x 2

Or Picks up 1 copy of Itinerary & Makes Chart

PAS stickers Chart and files.

RN Picks up Chart on day of surgery

PAS Schedules, Prints Itinerary (x1), stickers and facesheets

RN Picks up packet and creates/stickers chart & returns to front desk

Patient brings chart to OR waiting area for RN

BEFORE AFTER

Before After

Visual & Vertical

Prior to our Improving the flow work… patient charts lived incognito and created large batches….

Now they have a home And it’s clear to see when there is work to be done!

BEFORE AFTER

Forms

This group was really well organized already. Though it may have been difficult for someone else to step in and know where thing are or how to replenish items…

ENTER 5’s and KANBAN

BEFORE

AFTER

TO INFINITY AND BEYOND!!!Next we met as a group to discuss what we want the future of this Value Stream to look like

THINGS WE NOTED1) Many small changes had already improved some of the

steps, and added value to most of them. 2) We had to really focus on thinking about what we WANTED

the future to look like and look beyond the obstacles that were present NOW

CURRENT

FUTURE

The A3

Some Final Thoughts• Lean is a culture, a way of thinking, a

lifestyle. It’s hard but it’s worth it• Don’t be afraid to get off your keester

and see how things are done.• You don’t “DO LEAN”

• You have to use a team, be open minded and remember – JUST TRY IT