Lean Process

Lean Process

This process will assist you in leading, facilitating, and mentoring your process improvement team.

Step 1: Define value from the patient's perspective.

• Identifying the area to investigate
• Creating a sense of urgency
• Starting the charter
• Getting a champion
• Agreeing on the scope with the champion
• Assembling the core project team
• Developing a simple SIPOC map

Step 2: Map the value stream

A value stream is an end-to-end process that flows horizontally through an organization to provide value to a client, patient, or customer. 

To identify issues and constraints in a process, create a visualization of the value stream and where the issues and bottlenecks are believed to occur. Using a value stream map can help the team visually identify areas to focus on, and which issues and constraints have the greatest impact on the value stream's outcomes.

Horizontally value stream mapping of how an entity moves end-to-end through an

organization can offer many benefits beyond the traditional vertical way of thinking. This

method encourages organizations to take a patient-centered focus on how they manage

processes and measure success.

 

Step 3: Remove waste, and make the value flow without interruption.

The goal of this step is to develop ideas for addressing the root causes that impede process flow for the patient, or for any entity flowing through a value stream. Identify solution opportunities to eliminate, automate, or simplify.

During this step, no improvements are implemented. All ideas are on paper only and are listed as recommendations until the next step.

Step 4: Implement the solution, and allow patients to pull value.

Following the kaizen philosophy. The Japanese term kaizen translates as “good change”. In the United States, it is generally taught as a Lean principle and translated as incremental continuous change. The kaizen philosophy states that it is less problematic to take on smaller incremental changes one at a time than to attempt to change the entire value stream at once. Furthermore, over time the small changes result in significant changes to a value stream and often are completed in parts faster than trying to solve all the issues at once.

In order for change to occur, the project team must follow a robust change management approach.  Pilot, get feedback and tweak. Now that the new process is implemented with the changes in place, map the final version and document the new ways of working. Ensure version control by removing any old work instructions and replace with new ones.

Step 5: Maintain the gain, and pursue perfection.

Specify the value from the patient's perspective. Redefine newer and tougher targets. Continue until the champion feels that the process is good enough for now and that other processes need more attention. Continue to monitor the process to ensure that it does not degrade over time. Calibration and retraining are typically necessary. Monitor for 90 days, and prepare a closure report with before-and-after data.

References

Green, J., & Valentini, A. (2015). A Guide to Lean Healthcare Workflows. http://www.redbooks.ibm.com/redpapers/pdfs/redp5240.pdf