Lean routinization according to interviewees lean

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Lean Routinization According to interviewees, Lean provides a method for problem solving. Several interviewees expressed in one way or another that Lean processes (including the RCEs and the quick PDSAs) have become “what people do” at Suntown. Another interviewee noted that because of Lean, staff no longe r accept the “status quo.” Along those lines, one senior executive also noted that Lean penetration at the organization has caused staff to start questioning processes. Ultimate Outcomes Little information is available for the ultimate outcomes of efficiency, clinical outcomes, patient experience, patient safety, and business case (or value) at Suntown. Staff reported perceived increases in efficiency and patient experience; however, little quantitative evidence is available to support those perceptions. As noted in the previous section, Suntown has struggled to see sustained impact on clinical quality and patient safety. Efficiency and Standardization Efficiency gains projected because of Lean projects at Suntown are often estimated or projected during the RCE. However, the actual decrease in the number of “steps” and in non-value-added processes is not always confirmed after the RCE event. Nevertheless, hospital staff believe that adherence to the processes outlined in the RCE will provide for such efficiency gains. Further, Suntown does not collect cost data for Lean projects, unless the metrics are clearly defined and routinely collected as part of the work process.
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157 Efficiency. Nearly all interviewees reported that Lean projects resulted in reducing the amount of time a process takes, reassigning staff responsibilities, and using existing resources more efficiently. Further, the new processes resulting from each RCE had the potential to reduce the non-value-added steps, overall duration, and distance in terms of number of process steps. Estimated efficiency gains from administrative Lean projects not specifically studied in this project included: A reduction in the period for patient billing from 120 days to 50 days after an RCE event. Decreased time for processing long-term care admission by 60 percent, the number of steps in this process by 50 percent, and the number of handoffs to admit a patient from 15 to 4. According to a few interviewees, the E-Prescribe team has not yet observed all of the efficiency gains expected because of some initial time sunk into improving the electronic prescribing software, debugging the system, and getting providers on board. However, one senior executive and frontline staff who were interviewed foresee great time and cost savings for the organization and the patients once providers are fully using the E-Prescribe system. Standardization. Lean projects at Suntown may also result in new policies and procedures. As discussed previously, because of the UTI project, policies and procedures regarding hydration and cleaning procedures were standardized as a result of the RCE.
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  • Fall '17
  • Shankar Purbey

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