Case Study: LSI Tampa Lean Study

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.

CHALLENGE

EXECUTIVE SUMMARY

A planetree-designated, minimally-

Array partnered with Laser Spine Institute (LSI) to help facilitate their transition

invasive spinal surgery center was

from the current Orion surgery center to the new Avion Park facility. During this

interested in improving their patient

engagement, a multi-functional team of LSI stakeholders participated in six

experience and defining new operating

workshops to develop a transition plan for the new facility.

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

SOLUTION Kaizen Event 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

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 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 number of patients being scheduled for surgery, and improving the overall patient experience.

process. A gap analysis resulted in a transformation plan that the client could execute before moving to the new facility.

PROJECT HIGHLIGHTS

9%

Expected Increase in Value-Add Time

1.6 hr

Expected Clinic Duration Reduction

3

MRI Throughput Scenarios Tested

CLIENT PROFILE Laser Spine Institute Tampa, FL

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

Laser Spine Institute is recognized as the

how the process worked. After a full day of discussion and positive interactions,

leader in minimally invasive spine surgery.

the whole team began to see that there were possibilities for improving patient

Headquartered in Tampa, LSI’s Culture of

throughput, leading to capital gains and a better patient experience.

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. www.laserspineinstitute.com/tampa

TOOL

Figure 1: Current state process map showing process steps on large yellow notes and storm clouds on small pink notes.

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 decision-making to ensure all voices are heard and each stakeholder supports the final decision.

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.

Page 2 | Case Study

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 and applied collected data to a simulation model, which we used to test three scenarios.

Figure 2: Detailed imaging process map used to develop simulation model.

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.

The first scenario operates like the current

What are ways to test strategic planning options?

clinic, with a small change using a first in,

Our team of experts can help you evaluate

first out MRI queue rather than scheduling

the strengths and weaknesses of different

patients for a later MRI. The second scenario

strategic planning options. Whether you

utilizes a roomer to escort patients from the

are making decisions about department

waiting room to the changing rooms, where

adjacencies or endeavoring to analyze the

they perform a final metal screening. In the third scenario, X-ray techs escort

impact of hiring an additional surgeon, we

patients from the waiting room to the changing rooms and perform the final metal

provide the tools and talent necessary to

screening.

make the process easier.

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

Tools used:

to the appropriate destination, proved most effective. Based on these results, we

Consensus, Operations Analysis, Process

recommended using a first in, first out system for processing MRIs, which allows

Mapping, Simulation Modeling

patients to be seen in the order they arrive, reducing overall waiting time by about 50%.

Figure 3: Simulation model showing imaging suite operating with two X-ray technicians and one MRI technician.

Cast Study | Page 3

DISCOVERING YOUR HEALTHCARE SOLUTIONS TOGETHER We are innovators who specialize in the areas your system seeks out to leverage its valuable operational and facility resources. Array Advisors has the expertise and skills to reach beyond your milestones and provide you the decision support you need.

OUR SOLUTIONS

OUR SERVICES

We are dedicated to improvement.

How can we assist you?

Problem-solving and forward-thinking

We are Array Advisors, your trusted partners in Strategy Development, Organizational

individuals lead our efforts, which focus on your unique place in the healthcare delivery spectrum. Our knowledgeable staff can help you solve strategic business problems and develop a method to improve efficiency and utilization.

Transformation, and Facility Informatics. The challenges you face are not unique, but your solutions should be. Through a partnership of Strategy and Transformation we help you achieve and sustain. Our process begins by understanding your current operations and clearly defining your system’s goals before generating options. We employ a variety of integrated methods tailored to your strategic challenges, such as process mapping; operational planning; and healthcare real estate portfolio optimization, to help position your organization for future success.

MEET YOUR ADVISORS

Informatics Building Information Model management (BIM) is an enabler of most other technology trends in the Architecture, Engineering, Construction, Operations (AECO) industry, including but not limited to: sustainable design, offsite fabrication, LEAN construction, and energy efficient operations. Carefully considering how best to leverage virtual/digital representations of physical buildings can provide significant returns on innovation throughout the entire lifecycle of your facilities.

Strategy The need for healthcare real estate portfolio optimization has never been greater.

With the acceleration in mergers and acquisitions, as well as the evolution of clinical models, healthcare organizations must continuously evaluate their physical assets and maximize the value they derive from them.

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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Published: MAY 2016