Mapping Clinical Value Streams

Tens of thousands of patients die unnecessarily every year as a result of errors and defects in our healthcare processes. Those that survive often pay too much for the privilege. The value stream mapping methods described in Mapping Clinical Value Streams will help you achieve more efficient health care processes and will pave the way to an improved medical system with significantly reduced medical errors and other costly waste. Part of the Lean Tools in Healthcare series, this user-friendly book will help you understand how to use value stream mapping to provide quality, patient-centered care. Value stream mapping is a powerful tool for observing and depicting processes as they truly are—and for envisioning and reconfiguring the same processes to eliminate errors and other waste. With this book, you’ll learn how to: Map current-state processes Create a future-state map with processes streamlined through "flow" and "pull" Manage the rollout of your future state with "A3" project plans Presented in a highly organized and easy-to-assimilate format, the book includes examples from actual healthcare processes, plus numerous illustrations and margin assists that call your attention to key points. Value stream mapping icons make it easy to see and understand the ebb and flow of healthcare processes. Each chapter also includes a summary for quick review. Throughout the book you will be asked to reflect on questions that will help you apply these concepts and techniques to your own workplace. To be competitive in today’s marketplace, you cannot afford to leave processes unexamined, or let them become haphazard. You must apply conscious, quality attention to continuously see and fix your healthcare processes. In Mapping Clinical Value Streams, Shingo Prize-winning author Thomas L. Jackson shows you how.

In no industry is the concept of quality more essential than it is in healthcare, which is why the lean quality principles learned through the example of the Toyota Production System are so applicable. Two fundamental principles of Toyota‘s push for excellence are especially relevant to healthcare: ensuring quality at every step and keeping improve

Is Lean a fit for your healthcare organization? Various methodologies can be used to help organizations achieve their objectives depending on their criteria: lowest risk of failure, fast to resolution, or lowest cost for deployment. But what every organization should consider is which methodology will have the greatest impact. Lean, a systematic approach to understanding and optimizing processes, may be the fit for your organization. Learn more in this new IBM® RedpaperTM publication, A Guide to Lean Healthcare Workflows, by Jerry Green and Amy Valentini of Phytel (An IBM Company). The paper delves into the five steps of Lean: Define value from the patient's perspective Map the value stream, and identify issues and constraints Remove waste, and make the value flow without interruption Implement the solution, and allow patients to pull value Maintain the gain, and pursue perfection It describes each step in-depth and includes techniques, example worksheets, and materials that can be used during the overall analysis and implementation process. And it provides insights that are derived from the real-world experience of the authors. This paper is intended to serve as a guide for readers during a process-improvement project and is not necessarily intended to be read end-to-end in one sitting. It is written primarily for clinical practitioners to use as a step-by-step guide to lean out clinical workflows without having to rely on complex statistical hypothesis-testing tools. This guide can also be used by clinical or nonclinical practitioners in non-patient-centered workflows. The steps are based on a universal Lean language that uses industry-standard terms and techniques and, therefore, can be applied to almost any process.

One of the first steps in a Lean initiative is the development of several Value Stream Maps, flowcharts that document all of the processes required to deliver a product or service from start to finish. A hospital will have many different value streams that will need to be developed, including the work done in the OR. This readable book presents the Lean Roadmap for Value Stream Mapping in the OR, the steps needed to successfully complete a Value Stream Mapping project. Discussed are the steps to creating a Current State map, a Future State map, and a Master Plan to achieve the future state. Table of Contents Introduction to Value Stream Mapping Roadmap Chapter 1: Identify the Customer Chapter 2: Identify the Value Chapter 3: Identify the Processes Chapter 4: Draw the Process Relationships Chapter 5: Establish Process Times Chapter 6: Gather Process Ancillary Data Chapter 7: Identify Process Delays Chapter 8: Calculate Performance Metrics Chapter 9: Identify Sources of Waste Chapter 10: Brainstorm Solutions Chapter 11: Assign Solutions to Kaizen Events Chapter 12: Develop Kaizen Project Plan Chapter 13: Draw Future State VSM Chapter 14: Present Results Chapter 15: Epilogue

Lean techniques are tools that reduce waste in the process and create value for the end-customer. Initially, the concept of lean thinking started in manufacturing, but with the tremendous advantages it offers in terms of value creation for the customer, defect reduction, increase of profits for corporations, it has been recognized as an important tool across a wide spectrum of industries. Although Healthcare industry has started applying these techniques, there is very little work published on how to apply these techniques to this particular industry. In this study, a framework for applying lean thinking to healthcare industries is presented. The framework depicts a systematic methodology for identifying value streams. The framework was developed specifically for the healthcare industry, but it can be applied to service industry in general. A case study is presented on how to apply this framework. Value stream mapping has been conducted at a clinic to identify areas of improvement. The components of the developed framework have been used to define a future state of process based on input from process owners, nurses, physicians, and patient surveys. The study has identified factors that influence the success of implementation of lean techniques in healthcare. Also the potential for future work has been identified.

The book shows readers exactly how to use Lean tools to design healthcare work that is smooth, efficient, error free and focused on patients and patient outcomes. It includes in-depth discussions of every important Lean tool, including value stream maps, takt time, spaghetti diagrams, workcell design, 5S, SMED, A3, Kanban, Kaizen and many more, all presented in the context of healthcare. For example, the book explains the importance of quick operating room or exam room changeovers and shows the reader specific methods for drastically reducing changeover time. Readers will learn to create healthcare value streams where workflows are based on the pull of customer/patient demand. The book also presents a variety of ways to continue improving after initial Lean successes. Methods for finding the root causes of problems and implementing effective solutions are described and demonstrated. The approach taught here is based on the Toyota Production System, which has been adopted worldwide by healthcare organizations for use in clinical, non-clinical and administrative areas.

The Go-To Resource for Large-Scale Organizations to Be Agile Rather than asking, “How can we do agile at scale in our big complex organization?” a different and deeper question is, “How can we have the same simple structure that Scrum offers for the organization, and be agile at scale rather than do agile?” This profound insight is at the heart of LeSS (Large-Scale Scrum). In Large-Scale Scrum: More with LeSS, Craig Larman and Bas Vodde have distilled over a decade of experience in large-scale LeSS adoptions towards a simpler organization that delivers more flexibility with less complexity, more value with less waste, and more purpose with less prescription. Targeted to anyone involved in large-scale development, Large-Scale Scrum: More with LeSS, offers straight-to-the-point guides for how to be agile at scale, with LeSS. It will clearly guide you to Adopt LeSS Structure a large development organization for customer value Clarify the role of management and Scrum Master Define what your product is, and why Be a great Product Owner Work with multiple whole-product focused feature teams in one Sprint that produces a shippable product Coordinate and integrate between teams Work with multi-site teams