The itis infrastructure was recognized as a major

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cards) over the duration of this case study. The IT/IS infrastructure was recognized as a major constraint on improving efficiency in this and other processes. The team realized that the IT/IS infrastructure was largely inflexible and did not always suit the needs of surgical services staff. Heightened and continued engagement of the process owner and a surgeon champion was viewed as a major success factor. Physician satisfaction improved. A “business case scenario” was developed for funding the IT/IS upgrades. This scenario included a description of the project and anticipated outcomes to justify the financial investment. A process was defined and implemented to ensure that procedure cards are updated, current, and accurate. Although the percentage of accurate procedure cards cannot be confirmed (until the new IT/IS system is in place), staff felt that progress had been made in this area as a result of the new standard process. The amount of paper printed for procedure cards decreased from 600 sheets per week to 60 sheets per week. This reduction in printing is a result of fewer and more accurate procedure cards. The procedure cards event was also seen as a partial success in that nurses were pleased that they did not have to leave the room for supplies and surgeons appreciated the increase in accuracy with their equipment. However, the delay in the IT/IS upgrade caused great frustration for all staff involved. Exhibit 2.12. Outcomes by Category
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84 I do hear conversations around standardization and doing standard work that has become normal conversation. Those two terms are part of our culture now.” Department leader, procedure cards Outcomes of Lean In this section, we discuss the outcomes of the Lean initiative at Central based on information provided by interviewees (see Exhibit 2.12). The focus of this case study report is on the qualitative data collected, and thus it addresses mostly the process and perceived impacts of Lean. Where available, we provide outcomes data, including quantitative measures, provided by the hospital during the study. The discussion of Lean outcomes is organized into two major categories based on our conceptual framework: intermediate outcomes and ultimate outcomes. As described previously (see the Conceptual Framework section of this report), intermediate outcomes include culture change, employee satisfaction, change in Lean knowledge and skills, and Lean routinization. These outcomes can be viewed as intermediary to the ultimate goals of increased efficiency, increased patient satisfaction and experience, improved clinical processes and outcomes assessments, and increased patient safety. While the findings for outcomes are structured around our conceptual model, most data for outcomes for the hospital are related to employee satisfaction or frustration owing to Lean and increases and challenges to efficiency.
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