What is Lean

Document Sample
What is Lean
What is Lean?



Lean…the relentless pursuit

of the perfect process

through waste elimination …

Lean in Healthcare…









… can a manufacturing philosophy work for us?

2/

GE Performance Solutions /

6 19 January 2007

Imagine a hospital somewhere...









...and the patient's path through

5 different services. 3/

GE Performance Solutions /

19 January 2007

The dot exercise …

Demonstrating basic Lean principles

We need:

 Volunteers  Quick Registration Quick Registration

 Volunteers  Triage Triage



 Volunteers  Full Registration Full Registration

 Volunteers  Treatment Treatment



 Volunteers  Discharge Discharge

 Volunteers  Transport/Supplies Transport / Supplies

 Volunteers  Quality Assurance Quality Assurance

 Volunteers  Observers/Lean leaders



4/

GE Performance Solutions /

19 January 2007

Simulation I

Objectives



• To understand current state of a typical business through

a simulation exercise Quick Reg Triage Registration

(red) (green) (black)

What do I need to know

Treatment Discharge Quality

• Just be yourself (blue) (yellow) Assurance





• Understand the rules of simulation

• 5 minute simulation



Time remaining in

simulation: 0:00

0:05

0:10

0:15

0:30

0:45

1:00

1:15

1:30

1:45

2:00

2:15

2:30

2:45

3:00

3:15

3:30

3:45

4:00

4:15

4:30

4:45

5:00 Click here to begin timer





5/

GE Performance Solutions /

19 January 2007

Simulation I – debrief

Round

Target 1 2

Complete patients

(successfully) 20

Patients in process

(WIP) 5

Defective procedures

0

Patient cycle time 0:30



How did it feel?

What worked?

What didn’t work?

How could it be improved?

6/

GE Performance Solutions /

19 January 2007

Lean thinking fundamentals



Define value from the end Customer back

Identify the value stream

Establish flow

Pull from the supplier where you cannot flow

Continuously improve the process to perfection





7/

GE Performance Solutions /

19 January 2007

Defining value

Value Added Activity

Any activity that changes the

form, fit, or function of a Minimize Eliminate

product/transaction

— OR —

Something customers are willing

to pay for essential

waste unnecessary

waste

Non-Value-Added Activity

All other actions and unwanted value

features are by definition —

WASTE



8/

GE Performance Solutions /

19 January 2007

Defining value in A&E

Examples

Value add steps: • Procedure

Direct contribution to what patient values • Pt.

interaction

Value enabling steps:

• Lab tests

Required to allow value add steps to occur • Triage

Non-value added but essential steps:

Required by law or regulations • Registration



Non-value added steps: • Transit

Everything else! • Wait



Strict definition of value based on customer’s view

9/

GE Performance Solutions /

19 January 2007

Benefits of Lean …

. . . any process or value stream Higher customer

Lead Time / Cycle Time

satisfaction



Before • Reduced cycles

• Better delivery

Work . . .

Value Add Time

• More capacity

After • Better quality

Wait / Waste . . .

Non Value Add Time

• Productivity



Lean attacks waste



Increased process velocity, reduced

waste, improved customer experience

10 /

GE Performance Solutions /

19 January 2007

Using VSMs to identify

opportunities… OPPORTUNITY

• Reorganize

front end

process

• Standardize

Opportunity layout and

Opportunity streamline

throughput

• Accelerate

1 admitting

Opportunity 3 process

2 (admitting

physician)

IMPACT

• Reduced wait times and hand-offs

• Debottlenecking leading to reduced cycle times and increased

capacity

11 /

GE Performance Solutions /

19 January 2007

The 8 wastes in healthcare

Defects: Re-sticks, med errors

Overproduction: Blood draws done early to

accommodate lab

Inventories: Patients waiting for bed assignments,

lab samples batched, dictation waiting for

transcription

Movement: Looking for patients, missing meds,

missing charts or equipment

Excessive Processing: Multiple bed moves, re-

testing

Transportation: Moving patients to tests

Waiting: Inpatients waiting in ED, patients waiting

for discharge, physicians waiting for test results

Under-utilization: Physicians transporting patients 12 /

GE Performance Solutions /

19 January 2007

Flow

• Movement of products, services and

information down the value stream



• Objective is continuous flow as

product, service and information is

transformed by continuously adding

value



• Flow is created by eliminating

queues and stops, and improving

process flexibility and reliability

13 /

GE Performance Solutions /

19 January 2007

Pull





End customer pulls product/transaction through the

value stream

Each step pulls the product/transaction when needed

from the preceding step

Only the amount required is taken

No action is taken until the downstream process

initiates it





14 /

GE Performance Solutions /

19 January 2007

Improve to perfection cycle time



months

Reducing waste brings us closer to

perfection days

hours

As we reduce inventory/overproduction

in the process, bottleneck can be minutes

exposed and worked on as next steps seconds

Continuously find ways to improve the

process

Keep the customer in focus…are we

adding value?



Kaizen is the road to perfection…

15 /

GE Performance Solutions /

19 January 2007

Kaizen: the catalyst for improvement



Change process to apply the Lean

principles, targeting waste

Not traditional meetings…intense,

focus on action and speed



Key concept: try-storm instead of brainstorm

– New ideas are tried quickly, observe results

– Quick iterations: try-observe-improve and repeat

No money…it’s about creativity, not $ solutions



Hands on…turn ideas into action!

16 /

GE Performance Solutions /

19 January 2007

Are you ready for Round 2?

Make changes to your process based on what

you learned!

• Eliminate waste

• Improve flow

• Implement pull









5 minutes

Simulation II

Objectives



• To understand current state of a typical business through

a simulation exercise Quick Reg Triage Registration

(red) (green) (black)

What do I need to know

Treatment Discharge Quality

• Just be yourself (blue) (yellow) Assurance





• Understand the rules of simulation

• 5 minute simulation



Time remaining in

simulation: 0:00

0:05

0:10

0:15

0:30

0:45

1:00

1:15

1:30

1:45

2:00

2:15

2:30

2:45

3:00

3:15

3:30

3:45

4:00

4:15

4:30

4:45

5:00 Click here to begin timer





18 /

GE Performance Solutions /

19 January 2007

Simulation II – debrief

Round

Target 1 2

Complete patients

(successfully) 20

Patients in process

(WIP) 5

Defective procedures

0

Patient cycle time 0:30



How did it feel?

What worked?

What didn’t work?

How could it be improved?

19 /

GE Performance Solutions /

19 January 2007

GE Healthcare improved productivity

tremendously by LeanSixSigma

(+303%)









20 /

GE Performance Solutions /

19 January 2007

Lean principles



Lean

Transaction

• Single Piece Production System • Autonomation





Just-in-Time

Flow

• Stopping at









Jidoka

• Pull Abnormalities

Production

• TAKT Time

Production Heijunka



• Level Loading

• Sequencing

The House of Lean – More Advanced Lean

Principles 21 /

GE Performance Solutions /

19 January 2007

Any Questions?



Talk to the GE team during coffee or email

andrewarchibald@ge.com

Liz.howarth@ge.com

kevin.evans@ge.com

Ruth.nelmes@ge.com


Share This Document


Related docs
Other docs by guym13
by registering with docstoc.com you agree to our
privacy policy

You are almost ready to download!

You are almost ready to download!