BICS is based on two KEY THEMES and FIVE PRINCIPLES
The continuous removal of waste
For BICS, waste is any activity that takes up time or resource which does not contribute to directly satisfying the needs of the customer. There are eight types of waste:
Transportation
Inventory
Motion
Injuries
Waiting
Overproduction
Overprocessing
Defects
Moving things unnecessarily such as driving multiple journeys across Bolton as basic supplies have not been collected.
‘Stuff’ that is waiting to be worked. It could be patients on a waiting list, or excess stock being held.
Unnecessary human movement because things are not in the right place, for example walking up and down a department to obtain supplies.
Damage to people, such as a difficult layout causing someone to hurt themselves reaching, or through stress.
Waiting for something to happen, such as waiting for information or patients waiting for an appointment in a waiting room.
Doing too much, such as reordering items as it is not clear what is in stock, or requesting too many tests.
Making things more complicated than they need to be, such as duplicating records on both paper and computer based systems.
'Stuff' that is not right and needs fixing, such as incorrectly completed paperwork which needs re-doing.
All these things take time, energy and money. Many cause frustration for staff, waste the skills that you have, and can impact on our patients' experiences.
Respect for people and society
This is about involving the people who do the work, or are affected by the work, listening to their ideas, enabling and empowering them to make improvements. It is about supporting an engaged workforce where staff are not working within broken systems.
It is about offering the best services possible to our patients, carers, visitors and other customers.
The five key principles of BICS:
- Value - Understanding what the 'customer' perceives as value.
- Value Stream - How value is created and delivered to the customer.
- Flow - Smoothing the journey, removing all barriers and interruptions to deliver value, at the right pace, as efficiently as possible.
- Pull - Triggering processes on demand from the customer.
- Perfection - Developing a culture of continuous improvement.
1. What is Value?
We need our services to deliver value from our customer's point of view.
Value is something the customer wants, would be prepared to pay for, has a clear outcome, and is done correctly.
Understanding value is always the first step. If we don’t know what our customers want, improvements could be in the wrong area and customers remain dissatisfied.
For any service, there may be more than one customer, such as patients, carers, or other colleagues. Each customer may value different things.
2. What is a Value Stream?
A value stream is how we deliver a service from start to finish. It is how we deliver value to the customer. We need to understand the whole journey not just part of it in order to truly improve things. The delivery of any service will involve many depsrtments that all impact on quality. This includes anything from car parking, sending appointment letters, to seeing a clinician, getting treatment and follow-up care.
The work we do comes under two categories:
Example: Air Travel Example: Patient with a hernia
Value Added: Arriving at your destination Having the operation
Any activity that directly
contributes to satisfying
the needs of the customer
None Value Added: Waiting to check in Waiting for the operation
Any activity that uses time or
resources but does not directly
contribute to satisfying the
needs of the customer
Non Value added steps are examples of waste, and therefore, to make the biggest impact we focus on removing or reducing these wasteful steps from the process.
3. Flow
Flow is about making decisions or carrying out activities in the right order, at the right time, by people with the right skills, which help each patient or product to move smoothly through our systems.
This means putting the value-adding steps in the process as close together as possible either in time, or physically, to reduce waste.
What it is What it is not
Subway Sandwiches - makes your sandwich McDonalds - most hamburgers are pre-
fresh one at a time and fills it by 'flowing' made in batches and kept warm. Staff have
your sandwich along the counter. Staff move to run around between the burgers, fries
very little. and drinks
4. Pull
This means you don’t start doing a task until you are triggered by demand from the customer. Do not do it before you need to.
What it is What it is not
Making a cup of tea when you feel thirsty. Making 20 cups of tea in the morning, just in
case you feel thirsty throughout the day.
5. What is perfection?
Perfection is about creating a culture of continuous cycles of improvement. It is not about one-off projects, but seeing and eliminated waste and problem solving issues.
Remember the BICS Ground Rules
- There are opportunities for working differently - we can use the people we have much better - but there are no more people.
- We can use what we have in different ways - but there is no more resource.
- The space we have can be used much better but there is no more space.
- Improvement succeeds if it is designed and led by the people doing the job.
- Take part and get involved - ASK WHY!