Value Stream Analysis
The Lean journey starts with a Value Stream Analysis (VSA) event.
This exercise ensures that everyone understands the time and effort required in a process and challenges the entire team to start looking at their processes with a more critical eye identifying "value added and non-value added activities". The value stream event is an intense learn-by-doing process, through teams gathering data and conducting interviews with the workforce.
What happens on a VSA Event?
Define value - from the customer's point of view.
Current State Mapping - Map the current process to identify the time, effort and waste in a process and challenges the entire team to start looking at their processes with a more critical eye.
Ideal State - Identify what the process could look like in an ideal world.
Future State - Design the future process, based on customer value, the removal of waste and best use of equipment and resources.
Action Planning - Identifies activities (Rapid Improvement Events, Projects, and Do –its) to move towards the Future State.
Rapid Improvement Event?
"I hear and I forget. I see and I remember. I do and I understand!" - Confucius. When we run events we take teams out from the work place often for up to a week, to give them the time to work together to analyse and solve problems. An intensive week long event set up to:
- Make rapid change in week
- Engage and exploit the skills, talents and enthusiasm of the front-line staff (including clinicians)
- Identify and drive out waste and cost and liberate resources tied up in non-value added processes. Improve the quality of clinical care and the patient experience
A standard event is 5 days of rapid, focused, team action where the deliverable is a changed, more effective process that yields immediate improvements. The RIE daily pace is summarised as follows:
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Day 1 Study current conditions:
The RIE week begins with an official kick off by senior leadership that defines the teams' goals/objectives, team makeup, and approach for the week "empowering" teams to implement break-through changes during the RIE week. The RIE teams receive an overview of Lean principles and basic Lean tools. They validate the current conditions in each event team’s area, identifying wastes in processes and gathering data.
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Day 4 Standard work and Redeploy:
The RIE teams document standard work for "new processes" to ensure procedures are followed by work members. Establishing "standard work" is the heart and soul of the Lean transformation process and ensures that the "normal" condition is established. Also, appropriate staffing levels are put in place with product flowing by days end validating the new process. The teams, along with the leadership, will need to re-deploy employees in certain instances to ensure that the savings are realized.
6s?
6s is one tool in the Lean service improvement process. 6s is a systematic way of creating a safe, clean and orderly workplace and keeping it that way. 6s is a productivity tool not a clean up campaign. With the great premium place upon cleanliness, hygiene and safety 6s has a great detail to offer. Staff in those areas who have carried it out have found it hard work, but very rewarding as it makes daily working life much easier and reduces the amount of time taken for simple tasks.
In simple terms 6s is:
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2. Straighten - Organise what is needed
Have a place for everything and everything in its place. Use Visual Management to help improve workplace orderliness. Think not just about organisation, but also about eliminating wasteful motion and transportation of materials or equipment. Eliminate all closed-door and closed-drawer storage unless it's visual at a glance.
Go and See Rounds
Go and See Rounds have their foundation based on Lean principles "a place for everything and everything in its place" (remove hazards, chaos, overstocking).
The main aim is to create and maintain a clean, safe, bright and professional working area that gives patients confidence in the services that we provide.
From May, ward areas have been asked to look at 3 small things every week that could be changed to improve the environment. Matrons, Ward Managers and Departmental Managers regularly visit areas to monitor these improvements.
Areas that have implemented these small changes have had very positive feedback from both patients and staff.