Miami waste, they decided to eliminate the waiting

Miami
Children’s Hospital’s invested in lean in terms of
number of people, types of trainings and types of projects. Lean brought to the
department an ability to unite several different areas that were once very
segregated. PSAs’ had several different areas of responsibility prior to the
patient’s arrival scheduling, patient coming in and how they process the
paperwork. They used lean in all of those areas to streamline their processes.
They have several ways that they have utilised lean and one of it was their
Sterile Processing Department (SPD) where they worked on their trays and
especially one of the rooms that they worked in was the neurosurgery room. Then
they took it out to the suite to minimise the number of instruments in the tray
because they were counting all the instruments in the tray and they had to
minimize that number so that they can get the patients in the room on time. The
waste that they removed was inventory waste and waiting waste. For inventory
waste, they eliminated the materials that are on hand
as they do not required to do a lot of inventory. For waiting waste, they
decided to eliminate the waiting time so that patients get in the room on time
instead of waiting. With lean in place, they feel that
they have a nice specific format that they are following .

 

For
the first quarter, they did value stream maps for every division to identify
the potential waste and eliminate it. For the second quarter, they implemented
kaizen which means continuous improvement determined from the value stream maps
they constructed. In the last quarter, they reviewed 2008 and 2009 data to see
if any of the lean methodologies have increased their volume and realised that
it has increased across the border in all of their divisions. Miami Children’s Hospital’s discharge
process was probably the biggest lean implementation they did where they looked
at the entire spectrum which took at least 8 hours to get from the start where
the order was written for discharge to when the actual patient was discharged.
They were able to reduce it to about 3-5 hours by the end of the tri-storm
period in which they used a visual management tool which included bed boards
and initiated magnets in each of the patient’s bed board units so that they can
identify what process of not only the admission but the discharge the patient
was in. These bed boards are located in all of their inpatient nursing units.
It expedites and tracks what the timeliness are of the patient while they are
in the hospital. Lean has taught them on how to see the entire process in a
single piece flow so that they do not batch things. Batch may seem more
efficient to some staffs but what it really does is to slow down the process
significantly. By eliminating batching, they were able to save a significant
part of the whole process by 20% .

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In
conclusion, dissemination of lean throughout the organization has become a part
of their routine and in their future. They are also encouraged to see employees
thinking about lean when they perform their work everyday as they often say
that they need a value stream map which has become a forethought than an
afterthought. As they develop and continue on their journey of lean process
improvement, they think that they will continue to see that value back to the
patients and families and  their
satisfaction with not only them but also with their employees. Miami Children’s Hospital’s will continue to
drive this relentlessly until they eliminate errors/wastes and provide the most
optimal care at the best cost.