Design and building senior leadership visited nine

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Design and building. Senior leadership visited nine hospitals across the country to learn how they approached building new or replacement facilities. A steering committee of board members, senior leaders, and physicians was established to select an architectural firm. Working with the consulting firm, the steering committee prepared a request for proposal in 2005, which included a “test” or sample project that asked the architecture firm to apply Lean tools to a workflow assessment. LHC provided data to the firms to help them determine sizing and capacity. Responses from the firms ranged from 6 million to 12 million square feet and 291 to 396 beds. Firms that effectively used Lean tools found that fewer beds and less physical space were necessary to meet demand. This scenario analysis was used as part of the overall selection process. In March 2005, an architecture firm was selected. Between June and September 2005, LHC studied patient and staff experience and current-state mapping and technology roadmaps. Approximately 400 physicians, staff members, and patients participated in focus groups to identify concerns with the current hospital that could be addressed in the new hospital, as well as to identify the hopes and desires for the new facility. During the summer of 2005, frontline staff and patients were given disposable cameras and asked to use photojournaling to document issues they saw in their areas. Next, to identify areas for process improvement teams from each clinical area including a physician representative; if appropriate, a department leader (usually the nursing director); and an assistant nurse manager worked with a management engineer or Six Sigma Black Belt on process mapping. The process maps developed by teams from each clinical area helped inform the architecture firm as they drafted the design for each department. The teams viewed options for the designs and, together with the management engineers, evaluated the floor plans between October 2005 and January 2006 using current-state, future-state, and spaghetti maps. Key considerations for the design options were: Optimizing space utilization. Reducing staff movements or distance traveled to increase time at the bedside. Exhibit 6.11. Lean Tools for Horizon Hospital Photojournaling Voice of the customer: focus groups with staff and patients Process mapping Spaghetti mapping to show pathways of staff and patients through different processes Current and future-state mapping Critical patient clinical pathways Quality Function Deployment* Department-specific process improvements: Kaizen events/Lean projects, Six Sigma projects, Workouts, and Just-Do-Its Simulation *A systematic method to incorporate customer wants into process design to improve efficiency early in the design phase.
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228 Improving clinical quality and safety by building workspaces that facilitate the delivery of effective care.
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