CLIENT: Laser Spine Institute
CASE STUDY
Tampa, FL
Bringing together multi-functional teams to map the patient experience leads to discovery & improvement. Many times, team members solely focus on improving the work in their own department. When we bring all stakeholders together to form a multi-functional team, they see how different departments interact and realize that their focused improvements might not benefit the entire system.
SERVICE: Transformation
EXECUTIVE SUMMARY
METHOD: Kaizen Event
Array partnered with Laser Spine Institute (LSI) to help facilitate their transition from the current Orion surgery center to the new Avion Park facility. During this engagement, a multi-functional team of LSI stakeholders participated in six workshops to develop a transition plan for the new facility.
Challenge A planetree-designated, minimally-invasive spinal surgery center was interested in improving their patient experience and defining new operating procedures before moving into a new facility.
As Array led the team members through the mapping exercises, they developed a better understanding of how each piece of the clinic day fits together. The clinic workshops resulted in a detailed study around MRI utilization, and the potential value of roomers in the new, larger space. Array used a simulation model to test different scenarios and determine the best staffing option for the imaging department at the Avion Park facility. Upon completing the mapping events, a few key improvements became apparent to the team. Utilizing the transformation plan to guide these activities, LSI could see
Solution
potential increases in patient satisfaction and value-added process time. There was also potential for reducing the duration of the first clinic day, resulting in a larger
Array gathered a multi-functional team to participate in a kaizen event, where the team mapped the current state and ideal future state of the patient throughput process. A gap analysis resulted in a transformation plan that the client could execute before moving to the new facility.
PROJECT HIGHLIGHTS
9%
number of patients being scheduled for surgery, and improving the overall patient experience.
EXPECTED INCREASE IN VALUE-ADD TIME
1.6hr
EXPECTED CLINIC DURATION REDUCTION
3
MRI THROUGHPUT SCENARIOS TESTED
Client Profile LASER SPINE INSTITUTE TAMPA, FL Laser Spine Institute is recognized as the leader in minimally invasive spine surgery.
CURRENT CONDITIONS During the current state mapping session for LSI Avion Park’s surgical patient process, the multi-disciplinary team shared stories about their unique experiences around departmental interactions and uncovered some inconsistencies regarding how the process worked. After a full day of discussion and positive interactions, the whole team began to see that there were possibilities for improving patient throughput, leading to capital gains and a better patient experience.
Headquartered in Tampa, LSI’s Culture of Care begins with exceptional patient care, extends to their commitment to teamwork and comes full circle in their compassion for their community. Their goal to empower their patients through education includes educating patients about the entire patient experience– what to expect before, during and after the surgical procedure-so they can decide the best option for their needs. https://www.laserspineinstitute.com/tampa/
Method KAIZEN EVENT A kaizen event is a three- to five-day improvement event that brings together an multi-disciplinary team to solve a problem and create a lasting change. We facilitate these events using consensus-based decisionmaking to ensure all voices are heard and each stakeholder supports the final decision.
Figure 1: Current state process map showing process steps on large yellow notes and storm clouds on small pink notes. The group began to understand that improving each department individually might actually slow down the overall process. This realization lead to productive discussions about the importance of improving the system as a whole instead of focusing on individual departments and accidentally creating efficiency islands. FUTURE STATE As the team began discussing their ideal future state, they realized that making improvements in three major areas could lead to a more positive patient experience. The three areas of focus included changing steps in the patient acquisition process, developing a team-based provider assessment and organizing physiatrist interactions. Throughout the future state map development, which incorporated these changes, the team used a combination of existing data and experience to make assumptions about process step durations. The resulting future state process is expected to save patients up to 105 minutes of non-value added time at the clinic, increasing the patient value quotient to 53% from 44%, an impressive increase for a current state process that started with a high value quotient. To realize the gains seen in the future state, the team must complete additional transformation activities. These include specific tasks that contribute to improving the overall surgical patient experience. If completed, the team should expect to see the level of improvement demonstrated in the future state map.
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IMAGING STUDY The imaging department team was interested in increasing the number of MRI patients they see daily. In the Avion Park facility, the imaging department spans a larger area. Staff were worried this might impact patient navigation, and wanted to consider adding a roomer to increase the amount of time techs spend operating the imaging equipment. Staff mapped the imaging process for the Avion Park facility. The process map (Figure 2) contains two options: patients go directly to the MRI after their X-ray, or they change and wait before returning to the imaging department for the MRI. Array created a data collection form to reflect the detailed process map at the right. We analyzed
Transformation Our core mission is the same as that of our clients: improve the quality of our work, increase our efficiency, and motivate our staff to reach for success. At Array, we are establishing a culture of continuous improvement at all levels of our organization. We seek to empower team members to be agents for good change. We begin all endeavors by considering process before exploring solutions. Our team can guide your organization through pre-design, ensuring clear goal-setting; target outcomes; process analysis and design; and decision support. Our Lean-led approach to project definition provides a clear path to the right project before you begin to design.
and applied collected data to a simulation model, which we used to test three scenarios.
WHAT ARE WAYS TO TEST STRATEGIC
The first scenario operates like the current clinic,
PLANNING OPTIONS?
with a small change using a first in, first out MRI
Our team of experts can help you evaluate the strengths and weaknesses of different strategic planning options. Whether you are making decisions about department adjacencies or endeavoring to analyze the impact of hiring an additional surgeon, we provide the tools and talent necessary to make the process easier.
queue rather than scheduling patients for a later Figure 2: Detailed imaging process
MRI. The second scenario utilizes a roomer to
map used to develop simulation
escort patients from the waiting room to the
model.
changing rooms, where they perform a final metal
screening. In the third scenario, X-ray techs escort patients from the waiting room to the changing rooms and perform the final metal screening. The simulation study revealed that adding an MRI tech was not the most effective use of resources. Instead, the third scenario, in which X-ray techs escort patients to the appropriate destination, proved most effective. Based on these results, we recommended using a first in, first out system for processing MRIs, which allows patients to be seen in the order they arrive, reducing overall waiting time by about
TOOLS USED: Consensus, Operations Analysis, Process Mapping, Simulation Modeling
50%.
Figure 3: Simulation model showing imaging suite operating with two X-ray technicians and one MRI technician.
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case study: Laser Spine Institute - Tampa, FL | PAGE 3
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TRANSFORMATION Transformation and lean methods are very useful when focusing on operational process improvement. By bringing all constituents together and giving them the tools to experiment and test new ideas, current state barriers can be identified and transcended.
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