1. Lean Healthcare Deployment and Sustainability Chapter 3: Implementing Lean in Healthcare
Emma Grose
ETM 591

2. ETM 591 EEG Lean Healthcare Chapter 3
Value Stream Analysis
Value Stream Analysis (pg. 19):
Structured and facilitated
Series of interactive & evaluative steps
Eliminate waste & improve the flow of things
Flow (pg. 19):
Ideal process
No delays or bottlenecks
Does not (pg. 20):
involve any changes to the value stream and its processes
Does (pg. 20):
make a group analysis/planning effort that yields a rapid improvement plan
In essence (pg. 20):
the execution of the rapid improvement plan that creates change
ETM 591 EEG Lean Healthcare Chapter 3
Spring 2014

3. Process vs. Value Stream
Process (pg. 20): A set of steps that transforms one or more inputs into one or more outputs; comprised of four broad components
People
Procedures
Information
Equipment
Value Stream (pg. 20): A set of one or more processes that result in the delivery of a service or product that are typically high-level processes
ETM 591 EEG Lean Healthcare Chapter 3
Spring 2014

4. Emergency Department Value Stream
Processes
Disposition
Access
Diagnosis
Triage
Assessment
Registration
ETM 591 EEG Lean Healthcare Chapter 3
Spring 2014

5. Value Stream Transformation Model
VSA
Rapid Improvement
Just Do It
Project
ETM 591 EEG Lean Healthcare Chapter 3
Spring 2014

6. How to Improve a Value Stream?
Define value from the customer’s perspective
Understand the value stream and those steps that are value-added and non-value-added from the customer’s prospective
Make the value stream flow and reduce the cycle time by driving out waste
Continually strive for improvement
ETM 591 EEG Lean Healthcare Chapter 3
Spring 2014

7. Value-Added vs. Non-Value-Added
Value-Added Activities (pg. 22): Activities performed during the production or delivery of a service or product that increase its value to the customer
Criteria to be a value-added action (pg. 22)
It meets a customer need
It must be done right the first time
The action must change the product or service in some manner
ETM 591 EEG Lean Healthcare Chapter 3
Spring 2014

8. Value-Added vs. Non-Value-Added
Non-Value-Added Activities (pg. 23): Activities performed during the production or delivery of a service or product that utilize time or resources, but do not increase its value to the customer
Required (pg. 23): Due to regulatory, legal, or other requirements
Not required (pg. 23): Wasteany type of activity performed during the production or delivery of a service or product that utilizes time or resources but doesn’t increase value to the customer and is not required for legal, regulatory, or other reasons
ETM 591 EEG Lean Healthcare Chapter 3
Spring 2014

9. ETM 591 EEG Lean Healthcare Chapter 3
DOWNTIME
Defects
Overproduction
Waiting
Not Utilizing People’s Abilities
Transportation
Inventory
Motion
Excess Processing
ETM 591 EEG Lean Healthcare Chapter 3
Spring 2014

10. ETM 591 EEG Lean Healthcare Chapter 3
GLOSSARY
Value Stream Analysis (pg. 19): A structured and facilitated process through which a cross-functional team progresses methodically through a series of interactive & evaluative steps aimed at eliminating waste & improving the flow of things through the value stream
Flow (pg. 19): An ideal process state in which patients, products, or materials move smoothly through the process with no delays or bottlenecks
Process (pg. 20): A set of one of steps that transform one or more inputs into one or more outputs
ETM 591 EEG Lean Healthcare Chapter 3
Spring 2014

11. ETM 591 EEG Lean Healthcare Chapter 3
Glossary Continued
Value Stream (pg. 20): A set of one or more processes that result in the delivery of a service or product
Value-Added Activities (pg. 22): Activities performed during the production or delivery of a service or product that increase its value to the customer
Non-Value-Added Activities (pg. 23): Activities performed during the production or delivery of a service or product that utilize time or resources, but do not increase its value to the customer (required vs. not required)
ETM 591 EEG Lean Healthcare Chapter 3
Spring 2014

12. ETM 591 EEG Lean Healthcare Chapter 3
References/Contact Information
Dean, M.L. (2013). Lean Healthcare Deployment and Sustainability. Pages New York, NY: McGraw Hill.
Contact Information:
Emma Grose
ETM 591 EEG Lean Healthcare Chapter 3
Spring 2014