Operationalising lean in healthcare: the impact of professionalism

Rich

et al. 2020

SCM

Self Cite

Purpose This paper aims to explore patient to care provider reverse exchanges to improve the care processes and service supply chain using an online feedback platform. This paper demonstrates how a better understanding of timely and unsolicited feedback (“voice of the patient as a customer”) stimulates local interventions to improve service delivery and enact the essential characteristics of highly reliable organisations (HRO). Design/methodology/approach A realist approach involving an exploratory hospital case study using user feedback from an IT patient feedback platform. The methodology included interviews, secondary data and access to thousands of patient feedback narratives. Findings The findings show that a systems approach to the supply chain, using real-time feedback to enact process improvement is beneficial and a fruitful source of innovation for professional services staff. The setting of the improvement focusses on a true “voice of the customer” rather than attempting to improve arbitrarily internal process efficiency has major benefits for staff and their engagement with the right interventions to support higher performance. Practical implications The findings show major positive benefits for the adaptation and constant reflection of staff on the service provided to patients. The approach provides a means of reflecting as to whether the current supply chain and service provision are fit for purpose, as well as reliable, efficient and of value to the consumer. Originality/value This study is one of a few that adopt the consumer orientation needed to fully exploit the concepts of patient-centric improvement by including dynamic feedback in the supply chain and systems approach to care.

Section: Introductionmentioning

confidence: 99%

Creating highly reliable health care organisations through reverse exchanges

Rich

et al. 2020

SCM

Self Cite

“…Strategies such as empowerment, engagement, and leadership directly from the aides and nurses in discussion sections and, more importantly, in the decision-making process allowed the team to get into the implementation face and the project's success. The involvement of such stakeholders makes the difference between a success or a failure in the trajectory of a Lean or Kaizen project in the healthcare sector (Lindsay, Kumar & Juleff, 2020;Nino, Claudio, Valladares & Harris, 2020) One phrase that can be heard about healthcare is that standardization and standardized work are hard to implement because "every patient is different." There is no way to predict what can happen or be able to make every process the same.…”

Section: Discussionmentioning

confidence: 99%

An agile standardized work procedure for cleaning the operating room

Chipperfield¹,

Cosgriff²,

Nino³

et al. 2021

JIEM

Purpose: This research aimed to reduce the turnover time (non-operative time) in the operating room (OR) at a US Northwestern hospital. Design/methodology/approach: Data collection consisted of observation and interviews of the aides, circulating nurses, and surgical techs to identify causes of delays and long turnovers. It was determined that the turnover could be divided into two stages: cleaning the room and setting up for the next surgery. The research team met with the staff (aides) to create a standard operating procedure for the cleaning stage. It was decided to create an agile standard procedure that would allow the process to be completed the same way effectively with any number of people ranging from 1 to 3. The flexibility accounts for the number of people who are to complete the procedure and considers that some of them are only available during portions of the cleaning stage due to multiple turnovers or duties.Findings: The agile cleaning procedure reduced the cleaning time by 2.2 minutes (15.7% of the total time) and the standard deviation by 3.30 minutes. A decrease in variability represents more consistent turnovers, creating more predictable times for scheduling surgeries in the future.Originality/value: This research proposes a novel approach to standardized work that quickly adapts to the number of workers available. The agile standardized work procedure (ASWP) allows the process to be completed the same way every time effectively with any number of people.

“…One of the challenges that many teams have faced when applying lean tools in healthcare facilities is getting much-needed support and engagement from principal stakeholders such as medical professionals and administrators. The involvement of stakeholders could make the difference between a success or a failure in the trajectory of a lean project in the healthcare sector (Lindsay, Kumar & Juleff, 2020;Nino, Claudio, Valladares & Harris, 2020). In this study, the engineering team worked closely with administrators at the healthcare facility letting them know that their leadership and support made the difference in having impactful outcomes and reaching sustainability of the changes and improvements.…”

Section: Discussionmentioning

confidence: 99%

Improving the registration process in a healthcare facility with lean principles

Nino

Martínez

Gómez

et al. 2021

JIEM

Purpose: Process improvement in service industries, like the registration process in a hospital, can be achieved with the application of lean principles. In this specific case, lean principles were essential to analyze and improve patient satisfaction in a hospital in Montana. The clinics involved in the study included pediatrics (P), internal medicine (IM), and cardiology/pulmonary (CP). The purpose of this study was to address difficulties regarding patient satisfaction on the registration and check-in processes.Design/methodology/approach: Direct observations and patient surveys were initially made to understand the processes and identify the initial causes of dissatisfaction. A value stream map (VSM) was then used to break down even further the complexity of the patient flow. A Fishbone diagram and a concept map were completed to get to the root of the dissatisfaction.Findings: The information obtained from the lean tools showed that patients questioned the need for having a central registration in combination with the check-in process when this combination generates duplications of steps that cause unwanted delays. Several recommendations were explored by the engineering team to mitigate these delays and improve the registration process reducing the number of patients complaints by 40%.Practical implications: This project illustrated the application of Lean principles to resolve issues regarding a central registration format in a healthcare facility.Originality/value: A concept map was used as a tool that helps business organizations in the development of creative and new ways of looking and solving process deficiencies.