The Kay Jeweler Pavilion: Creating Value for Kids, Families and a Community Ohio House Healthcare Efficiencies Study Committee – September 16, 2015

Lean manufacturing, lean enterprise, or lean production, often simply, "Lean", is a production practice that considers the expenditure of resources for any goal other than the creation of value for the end customer to be wasteful, and thus a target for elimination. Working from the perspective of the customer who consumes a product or service, "value" is defined as any action or process that a customer would be willing to pay for.value Essentially, lean is centered on preserving value with less work. Lean manufacturing is a management philosophy derived mostly from the Toyota Production System (TPS) (hence the term Toyotism is also prevalent) and identified as "Lean" only in the 1990s. [1][2] TPS is renowned for its focus on reduction of the original Toyota seven wastes to improve overall customer value, but there are varying perspectives on how this is best achieved. The steady growth of Toyota, from a small company to the world's largest automaker, [3] has focused attention on how it has achieved this success.Toyota Production System [1][2]seven wastesToyota [3] From Wikipedia

Integrated project delivery (IPD), is a collaborative alliance of people, systems, business structures and practices into a process that harnesses the talents and insights of all participants to optimize project results, increase value to the owner, reduce waste, and maximize efficiency through all phases of design, fabrication, and construction. From Wikipedia

5-Party Agreement Owner Children’s Hospital Medical Center of Akron (Akron Children’s Hospital) Architectural Team Construction Management Team Hasenstab Architects, Inc Akron, OH. HKS, Inc. Dallas, TX. Welty Building Company, LLC Akron, OH. The Boldt Company Appleton, WI.

Waive liability and claims against each other Indemnify each other against a limited number of acts or omissions Have profit for Project fixed Place 100% of profit at risk Participate in the Incentive Compensation Plan, if invited Are covered by a Project specific insurance program Agree to a binding dispute resolution process All ILPD Team Members

All members of the team are required to have Lean education Includes architects, interior designers, construction, all trades Lean Boot Camp – 2 full days of learning, collaboration and fun Concepts include one piece flow vs batching, “fresh eyes”, 5S, Visioning, Value Stream Mapping Lean Education for the Team

Who is part of the clinical design team? All team members including physicians, surgeons, nurses, therapists, administrators, clerical, and support staff have representation Commitment includes Lean Boot Camp, team meetings, all workshops including the initial 3P workshop, Functional Workshop and Detail Workshop Participation in Scenario development to test the space in mock up Abides by group developed Team rules Takes a role in scenario testing Shares with staff in their unit Gives tours to coworkers Participate, Participate, Participate! Clinical Design Teams

Visioning and 3P Process

Full Scale Mock Ups

High Fidelity Testing During Detailed Design Workshop

Project Metrics Project Cost: Original estimate - $221,888M Target cost - $182,255M Final cost - $176,938M* * added value included - $8.5M Project Schedule: Construction Start Date – 04/15/13 Original construction completion – 04/15/15 Actual construction completion – 02/20/15* * included 37.5 lost weather days

Economic Impact Goal: ≥70% of Project dollars will be spent on local labor Actual: greater than 80% of Project dollars spent on local labor Opening Day May 5, 2015

NICU - Patient & Family Satisfaction

Questions?