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Lean Healthcare
Presented by:
Melanie Sudduth
Director of Lean Healthcare South Carolina
[email protected]
864-354-4773
Why Are We Here Today?
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Provide a brief introduction to SCMEP
Provide an overview of Lean Healthcare
Spotlighting
- Lean – An Overview of the Tools
- reVIEW Program
- TWI
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.
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Mission - To Strengthen the Global Competitiveness of
South Carolina Businesses
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Vision - To be a primary resource for the South Carolina
business community in providing highly-valued
technological, workforce, and business solutions that
improve competitiveness
Services for Business
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Executive Leadership Services (Strategic Planning, M&A,
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
SCMEP – Impacts for 2008
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Companies Served
Investment
New and Retained Sales
Cost Savings
Jobs Created/Retained
Overall Economic Impact
1,823
$36.3 MM
$152 MM
$49.9 MM
1,360
$254.8 MM
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
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.)
Lean = Eliminating NVA
Value-Added
Non-Value-Added (Muda)
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Overproduction
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Waiting
•
Confusion
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Processing
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Inventory
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Defects
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Motion/Travel
Typically >60% of the total lead time is non-value-added.
Overproduction
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Producing more than is required by the next
process
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Producing earlier than is required by the next
process
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Producing faster than is required by the next
process
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Examples of overproduction:
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Duplicate charting
Multiple forms with the same information
Copies of reports sent automatically
Inventory Waste
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Any supply or purchase in excess of the current
demand
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Examples of excess inventory:
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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 – can’t find it, so we buy more
Defects/Errors
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Inspection and correction of mistakes
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Examples of Defects/Errors:
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Wrong dosage/wrong medication administered
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Rework of any kind
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Inconclusive tests
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Incorrect charges/billing
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Surgical errors
Processing Waste
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Effort that adds no value from the
patient/customer’s perspective
Examples of processing waste:
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True requirements not clearly defined – Clarifying orders
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Extra copies or excessive information
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Missing medications
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Regulatory paperwork
Waiting Waste
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Idle time created when people, information,
equipment or materials are not at hand.
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Examples of waiting waste:
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Waiting on test results
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Waiting on doctor/nurse, etc.
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Waiting on availability of equipment or treatment rooms
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Waiting on cleaning of rooms
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Waiting for “now” medications
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Waiting on supplies
Confusion
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People doing the work are confused or not sure
about what should be done.
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Examples of confusion:
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Unclear MD orders
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Unclear route for medicine administration
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Unclear system for indicating charges for billing
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Same activities being performed different ways different people
Motion/Travel Waste
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Any movement of people, equipment, supplies,
etc. that does not add value.
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Examples of motion waste:
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Looking for information, supplies, people, etc.
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Supplies not located at point of use
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Unfavorable layout
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Supplies not prepped prior to patient treatment
Lean Building Blocks
Continuous Improvement
Pull/Kanban
POUS
Cellular/Flow
Quality at Source
Standardized Work
Visual
Quick Changeover
Batch Reduction
5S System
TPM
Teams
Facility Layout
Value
Stream
Mapping
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:
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People
Materials
Methods
Equipment
5S – Workplace Organization
& Standardization
5S =
Sort
A safe, clean, neat
arrangement of the
workplace provides a specific
location for everything, and
eliminates anything not
required.
Set in Order
Shine
Standardize
Sustain
Visual Controls
Simple signals that provide an immediate
understanding of a situation or condition. They are
efficient, self-regulating, and worker-managed.
Examples:
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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)
Facility Layout
Teams
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Teams Cross-trained and multi-skilled personnel
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Teams for Continuous Improvement
Process quality, not inspection
Decision-making done by those doing the work
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Problem solving teams
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Setup or Changeover Reduction
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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:
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Improvement of capacity and volume
Increase in flexibility
Increase in competitiveness
Increase in Patient Satisfaction
Increase in Physician Satisfaction
Impact of Batch Size
Reduction
Batch and Queue Processing
Process
Process
Process
A
B
C
10 min.
10 min.
10 min.
30+ min. for total order, 21+ min. for first piece
Continuous Flow
Processing
Process
Process
Process
A
B
C
12 min. for total order,
3 min. for first part
Point Of Use Storage (POUS)
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Materials, Supplies and Equipment is where used
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Benefits:
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Reduced Motion/Travel
Decreases patient delays
Increases patient throughput
Reduces confusion and “searching’
Quality at the Source
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Personnel must be certain that work is being
performed correctly
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Techniques used:
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Samples or visual standards
Process documentation defining quality requirements
Poka Yoke – Mistake Proofing Techniques
Root Cause Analysis Tools (A3 Problem Solving)
Push versus Pull Systems
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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
Cellular Flow
Linking of processes into the most efficient
combination to maximize value-added content
while minimizing waste.
Total Productive
Maintenance (TPM)
Systematic approach to the elimination of the
six major equipment losses:
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Setup and adjustment
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Breakdowns
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Idling and minor stoppages
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Reduced speed
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Startup
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Defects and rework
Conclusion
Lean
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Simple and visual
Patient driven
Supplies as needed
Reduce non-valueadded
Minimal lead time
Quality Controls
Value stream
managers
Traditional
• Complex
• Internally driven
• Excessive supplies
• Speed up valueadded work
• Long lead time
• Rework & Errors
• Functional
departments
Thank You.