Lean-Led Hospital Design

Integrating Lean Exploration Loops Into Healthcare Facility Design

“…We found our process mapping and analysis activities during these EWOs to be very effective, due to the fact that they involved a small but diverse selected group of individuals, including physicians, leaders, nurses, and other frontline professionals, to identify and resolve critical design gaps. Similar findings and conclusions were drawn by other scholars (Eaton, 2013; Grunden & Hagood, 2012; Lazarus, 2013; Shepley, 2011; Zimring et al, 2008). At this level of analysis, the individuals were able to visualize and test designs in proposed layouts, while taking into account the potential locations of furniture, storage, equipment, technology, and other interior details.…”

“…Open and honest discussion about past system failures and patient harms, without fear of punishment or embarrassment, was encouraged during these activities (Edmondson, 1999; Sexton, Thomas, & Helmreich, 2000; Weingart & Page, 2004). Furthermore, a number of commonly used Lean system design concepts such as just-in-time inventory, workload leveling, mistake proofing, and setup time reduction were introduced to the participants by Lean facilitators and incorporated into the discussions during the rounds of meetings and EWOs (Eaton, 2013; Grunden & Hagood, 2012).…”

“…Although there were some clear and quantifiable differences between these two design concepts, these differences were not, in the Lean team’s opinion, sufficient evidence by themselves to recommend one design over the other. Other safety, operational, and financial factors needed to be considered and weighed appropriately by project leadership alongside the results of the analyses provided by the Lean team (Ferris, 2013; Grunden & Hagood, 2012; Zimring, Augenbroe, Malone, & Sadler, 2008).…”

Effects of Unit Design on Acute Care Nurses’ Walking Distances, Energy Expenditure, and Job Satisfaction: A Pre–Post Relocation Study

“…The two primary nonvalue-added tasks for nurses are searching for equipment and lack of access to supplies (Storfjell et al, 2008; Tucker & Spear, 2006). Other nonvalue-added tasks include acclimating to multiple room configurations and inconsistent layouts, maneuvering through cluttered rooms with equipment and furniture in the path of travel, convoluted paths for patient transfers, and hauling trash and soiled linens long distances (Grunden & Hagood, 2012; Hadfield & Holmes, 2008). Not only do nonvalue-added tasks steal nursing time away from patients, potentially affecting patient outcomes, they are costly.…”

The Creative Healthcare Architect

“…A potential counter balance to this risk-aversion bias are techniques advocated by the Lean process—rapid cycle testing, prototyping, and gaming (Grunden, 2012). Rapid cycle testing seeks to create short, real-time prototype tests of operational concepts.…”