Lean for Hospital

Page 1

LEAN FOR HOSPITAL HCMC, May 31 - Jun 11, 2017

"Efficiency is doing things right; effectiveness is doing the right things" -- Peter Drucker --


LEAN FOR HOSPTIAL 2017

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INTRODUCTION

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DEFINE

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MEASURE

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MEASURE (continued)

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ANALYZE

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ANALYZE (continued)

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IMPROVE

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IMPROVE (continued)

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CONTROL

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FACILITATION SKILLS

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CHANGE MANAGEMENT

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PROJECT MANAGEMENT

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PROJECT MANAGEMENT AND DMAIC RELATIONSHIP


LAN P. NGUYEN, MBA, MS, LSSBB PENNSYLVANIA, USA lan.nguyen1@temple.edu

Lan Nguyen is an industrial engineer specializing in Quality Controls, development and management. She has accumulated over 5 years of experience working in healthcare organizations - Temple and Main Line Health Systems – they are one of the largest health systems in the region. She has an extensive work in process, work-flow re-engineering and redesign through the application of Lean and Six Sigma tools with a focus on customer care, total quality management and information systems utilization. Many projects were implemented and had high impacts to the bottom line of the organizations. She is one of the young and upcoming leaders in Main Line Health System. She is 

Astute, healthcare executive with broad and deep expertise in driving operational breakthroughs, offering innovative solutions and insights focused on strategic organizational effectiveness and efficiency

Proven leadership skills and highly proficient in identifying opportunities, implementing solutions and building relationships to achieve successful outcomes

Creative and analytical thinker with the ability to link tactical plans with long range strategic visions.Her current position is a Process Improvement Engineer at Lankenau Medical Center (Main Health System, PA). Main Line Health System has been recognized by the U.S. News and World Report’s “Best Hospital” rankings as among the top 10 in Pennsylvania Region, with more than 10,000 employees and 2,000 physicians.

Lan is responsible in directing Green Belt engineers working on daily operational activities from many departments ranging from Emergency to Operations, from inpatients to outpatients service lines. As a Sig Sigma Black Belt, she is committed to ensuring all operational excellence in achieving any and all aspects of the organization. She has a strong passion towards Lean tools in solving complex issues of the administrational and operational aspects and provides the best care to the patients.

Specialties: Process Management and Redesign, Project Management, Patient Flow Management, Revenue Cycle Operations and Improvement, Lean Six Sigma Methodology, Strategic Planning and Business Development, Information Systems Implementation.

Education: o

o

In the United States: 

M.B.A with Health Section Management and Finance

Master of Science in Chemistry (specialized in Nanomaterials and Analytical)

Bachelor of Science in Chemistry and Industrial Engineering

In Vietnam: 

o

Bachelor of Secondary Education

Certifications: 

Certified Lean Six Sigma Black Belt

Accounting Certificate


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Source: Wikipedia

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NORMAL DISTRIBUTION CURVE

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Process Step #1

• Nursing • Physicians • Care Management • Patient

Patient registers for procedure

Process Step #2

• Admission Assessment • H&P • EMR

Patient prepped

Process Step #3

Process Step #4

• Discharge Instructions • Care Coordination

Procedure conducted on patient

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Patient Home Health LTAC SNF

Patient sent to recovery room

Patient discharged

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HOSREM & PHM › LEAN FOR HOSPTIAL 2017 › MEASURE

Six Sigma’s DMAIC: The project management framework used by MLH for Process Improvement (PI) projects

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σ

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Gemba Walking at the Cleveland Clinic

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Output of Interest = A function of key inputs y = f(x1, x2, x3…)

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Step 5

Action Allow the participants to generate ideas (in silence).

• Review the requirements for documentation.  If using Post-it Notes: One idea per note, legible, able to be read at a distance, and use concise statements. 6

Gather ideas from the team members. • You may do a round-robin where people state one idea at a time or do an open brainstorming forum where anyone can speak up at any time. • Do not judge the ideas while they are gathered; only ask clarifying questions. • If not using Post-it Notes: Document the ideas by writing down the ideas on a flip chart or white board or post them on a flipchart. • Continue until everyone is out of ideas.

7

Organize the captured ideas: Affinitize/categorize as appropriate.


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Define

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Measure

Analyze

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Manpower

Machine

(Personnel, Staff, People, etc.)

(Technology, Equipment, Tools, etc.)

Anything that affects the knowledge and/or skillset of the workers in a process. Consider: Training, Certifications, etc.

Any type of physical or computer-based tools used in the process. Consider: Computer software/hardware, Handheld tools, etc.

Method

Measurement

(Process, Practice, etc.)

Processes that are captured in formal policies and procedures, informal standard work, or industry bestpractices. Consider:

Includes any activities that inspect or check your process to help meet the required outputs. Consider: Inspection points or inspection criteria, Measurement devices, Audits, etc.

Material Material (Supplies, (Supplies, Consumables and Consumables Information, etc.)and Information, etc.)

Any consumables or thingsAny used that aren’t consumables or necessarily a thingslisted used in that “machine” the otheraren’t category. This necessarily a category is of value “machine” listed because it typically in thethe other addresses category. ofThis characteristics category specific items inis aof value it process andbecause the issues typically related to their quality addresses the or control. characteristics of specific items in a process and the issues related to their quality or control.

Environment (Workplace, etc.)

Any characteristics of the place where the process occurs. Consider: Brightness, Temperature, Humidity, Noise levels, etc.


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 I BLAME YOU!

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The Fault Tree

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Example 1

Example 2

Example 3

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Touch =70-110 min

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Gap Analysis

Prioritization Matrix

Implementation Plan


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DAY 4: CLOSURE

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HOSREM & PHM › LEAN FOR HOSPTIAL 2017 › IMPROVE

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Demand

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OVERVIEW: PROCESS IMPROVEMENT

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Issue

Facilitator Best Practices

A Participant Has Not Contributed or Group is Generally Not Participating

• • • • • •

Participants Ask Your Opinion

• Acknowledge the question and remind the group of facilitator’s neutrality • Restate the question, ask group to respond

Use active listening techniques Comment on what you observe Remind them of the importance of participation Call on quiet people - carefully Change techniques (e.g., round robin) Refer to ground rules

Group is Skipping Tasks, Jumping to Conclusions, etc.

• • • • • • •

Comment on what you observe (process) Adjust body language and voice tone Adjust technique Remind the group of the ground rules Round robin Pro/Con discussion Reiterate to the group the value of the tasks they want to skip

An Idea is Not Well Stated

• • • • •

Use active listening to draw out the idea Provide non-verbal encouragement, paraphrasing, clarification Restate the idea and ask for confirmation Thank the participant for their contribution Once the idea is clarified then record it for the team


HOSREM & PHM › LEAN FOR HOSPTIAL 2017 › FACILITATION SKILLS

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212

FACILITATION SKILLS ‹ LAN NGUYEN

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o

• • o

• •

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HOSREM & PHM › LEAN FOR HOSPTIAL 2017 › FACILITATION SKILLS

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FACILITATION SKILLS ‹ LAN NGUYEN

CHANGE MANAGEMENT

36


HOSREM & PHM › LEAN FOR HOSPTIAL 2017 › FACILITATION SKILLS

CHANGE MANAGEMENT

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FACILITATION SKILLS ‹ LAN NGUYEN

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• o

o o o

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HOSREM & PHM › LEAN FOR HOSPTIAL 2017 › FACILITATION SKILLS

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CHANGE MANAGEMENT ‹ LAN NGUYEN


HOSREM & PHM › LEAN FOR HOSPTIAL 2017 › CHANGE MANAGEMENT

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CHANGE MANAGEMENT ‹ LAN NGUYEN

CHANGE MANAGEMENT

9


HOSREM & PHM › LEAN FOR HOSPTIAL 2017 › CHANGE MANAGEMENT

CHANGE MANAGEMENT

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HOSREM & PHM › LEAN FOR HOSPTIAL 2017 › PROJECT MANAGEMENT

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PROJECT MANAGEMENT ‹ LAN NGUYEN

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HOSREM & PHM › LEAN FOR HOSPTIAL 2017 › PROJECT MANAGEMENT AND DMAIC RELATIONSHIP

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PROJECT MANAGEMENT AND DMAIC RELATIONSHIP ‹ LAN NGUYEN

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HOSREM & PHM › LEAN FOR HOSPTIAL 2017 › PROJECT MANAGEMENT AND DMAIC RELATIONSHIP

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12

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HOSREM & PHM › LEAN FOR HOSPTIAL 2017 › PROJECT MANAGEMENT AND DMAIC RELATIONSHIP

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PROJECT MANAGEMENT AND DMAIC RELATIONSHIP ‹ LAN NGUYEN

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24

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