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

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

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

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

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

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

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

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

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

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

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

ETM 591 EEG Lean Healthcare Chapter 3 References/Contact Information   Dean, M.L. (2013). Lean Healthcare Deployment and Sustainability. Pages 19-23. New York, NY: McGraw Hill. Contact Information: Emma Grose Emma.e.grose@live.mercer.edu ETM 591 EEG Lean Healthcare Chapter 3 Spring 2014