The End to End Journey Challenge
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by Daniel T Jones of Lean Enterprise Academy shown at the 2nd Lean Healthcare Forum on 6th June 2006 ran by the Lean Enterprise Academy www.leanuk.org
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The End to End Journey Challenge
- 1. 1 Lean Enterprise Academy www.leanuk.org Creating the Lean Patient Journey from Beginning to End Daniel T Jones Chairman Lean Enterprise Academy
- 2. 2 Lean Enterprise Academy www.leanuk.org Welcome • To the second Forum of the Lean Healthcare Network in the UK • An independent network to help accelerate the implementation of lean across the NHS • Building on the work of the pioneers of lean healthcare in the NHS and across the globe • And the Lean Enterprise Academy’s experience as catalysts in experiential learning • Helping pioneer organizations to quickly get started down their own lean journeys • Then writing up the methods for others to follow
- 3. 3 Lean Enterprise Academy www.leanuk.org The Power of Lean • Purpose – starting point is value defined from the customer’s perspective • Process – set of principles for redesigning value streams – the patient journey, the diagnosis and treatment process and the support processes • People – organisation and management system based on developing people as problem solvers – Toyota the most powerful reference model • TQC and Six Sigma – analyse causes of variance • TPM – improve equipment availability • Theory of Constraints – manage bottlenecks • Systems Theory – optimise whole systems
- 4. 4 Lean Enterprise Academy www.leanuk.org Levels of Action • Point Kaizen – create islands of flow, remove waste, establish standard work, roll out 5S etc. – learn to change things quickly but difficult to sustain in isolation • Value Stream Kaikaku and Kaizen – redesign of the end-to-end patient journey, the whole diagnosis and treatment process and demands on the support processes • System Kaizen – redesigning the series of organisations across which the different value stream flow – and building a management system to sustain and develop the value streams
- 5. 5 Lean Enterprise Academy www.leanuk.org For the Patient - 6 Trips, 100 minutes of Value, 610 minutes Time, over 31 weeks For Healthcare – 100 minutes of Value, 330 minutes Time, over 31 weeks Secre- tary Pre Op Assess Test Follow Up Appt. Follow Up Test To Come List Ops. List Admi- ssion Proce- dure Disc- harge Test 5th Visit Book- ing Outp. List Refer Outpat. Appt. Test Wait Hospital Test GP Visit GP VisitGP
- 6. 6 Lean Enterprise Academy www.leanuk.org
- 7. 7 Lean Enterprise Academy www.leanuk.org The Lessons • The objective is to Improve the quality of the patient’s journey – as well as improving working conditions and lowering the cost to the taxpayer • Seeing the whole process is the starting point • Learning where you can flow comes next – distinguishing the green and red streams • Then redesigning the green stream so it flows, instead of planning everything as if it were red • Which gives a purpose and direction to all the detailed improvement activities • Rapid change is not only possible – it is essential – what sticks is what you do yourselves
- 8. 8 Lean Enterprise Academy www.leanuk.org Today’s Agenda • Seeing the End-to-End Patient’s Journey – mapping the 18 week elective process • Understanding the Gains from lean • Two breakouts on key pieces of the system – Pathology and Radiology • Two breakouts on Running your own Rapid Improvement Events and Mapping the End-to-End process • One additional breakout on Applying Lean to Primary Care – the next frontier • The Flinder’s Story from down under • Discussion of the change management issues – and what we need to tackle for next time
- 9. 9 Lean Enterprise Academy www.leanuk.org Creating the Lean Patient Journey from Beginning to End Daniel T Jones Chairman Lean Enterprise Academy