1. Sydney Herrin Lean Healthcare Deployment and Sustainability Chapter 10: Standardize Best Practices

2. Slide 2Spring 2014ISE 428 ETM 591 SLH Lean Healthcare Chapter 10 PDCA (p. 87)  Planned  Done  Checked  Act  Eliminate Barriers  Ensure there is a stable Quality Management System (QMS)  Ensure that new and improved processes are hardwired

3. Slide 3Spring 2014ISE 428 ETM 591 SLH Lean Healthcare Chapter 10 What is a Stable System? (p. 87)  Consistent adherence to well-defined policies and procedures.  Two pieces:  Policies and procedures exist  They are followed  ISO 9000

4. Slide 4 Example: Operating Room Turnover (p. 89)  Average: 93 minutes  Significant daily variation  Points outside control limits  Out of control Spring 2014ISE 428 ETM 591 SLH Lean Healthcare Chapter 10 Source: Dean Figure 10.1 (System out of control)

5. Slide 5 Example: Operating Room Turnover (p. 89)  Average: 87 minutes  No points outside control limits  More stable and predictable  In control Spring 2014ISE 428 ETM 591 SLH Lean Healthcare Chapter 10 Source: Dean Figure 10.2 (System in control)

6. Slide 6 Example: Operating Room Turnover (p. 90)  Average: 46 minutes  Average significantly decreased  Narrower control limits  Improved Spring 2014ISE 428 ETM 591 SLH Lean Healthcare Chapter 10 Source: Dean Figure 10.3 (Improved system in control)

7. Slide 7 Successful Improvement Requires a Stable System (p. 91) Spring 2014ISE 428 ETM 591 SLH Lean Healthcare Chapter 10 Source: Dean Figure 10.4 (Relationship between a stable system and process improvement)

8. Slide 8Spring 2014ISE 428 ETM 591 SLH Lean Healthcare Chapter 10 How Do I Do It? (p. 91)  Step 1: Eliminate Barriers  Identify during transformation support meetings  Ensure an environment of open and honest inquiry

9. Slide 9Spring 2014ISE 428 ETM 591 SLH Lean Healthcare Chapter 10  Step 2: Ensure There Is a Stable QMS  Infrastructure Corporate office headed by executive reporting to CEO Sufficient support staff Quality Management Council How Do I Do It? (p. 92)

10. Slide 10 How Do I Do It? (p. 92)  Step 2 cont.  Quality Management System Documented policies and procedures Structure for reviewing and updating policies and procedures Internal audit system Rigorous training and development program Corrective and preventive action system Continual improvement component Spring 2014ISE 428 ETM 591 SLH Lean Healthcare Chapter 10

11. Slide 11Spring 2014ISE 428 ETM 591 SLH Lean Healthcare Chapter 10 How Do I Do It? (p. 93)  Step 3: Ensure That New and Improved Processes Are Hardwired  Ongoing review and oversight to ensure QMS documentation is continually updated QMS is responsive to external requirements and internal improvements Work instructions are developed, documented, and updated at process level Policies and procedures are developed, documented and updated at the healing pathway level New opportunities are identified and implemented A culture of continual improvement

12. Slide 12Spring 2014ISE 428 ETM 591 SLH Lean Healthcare Chapter 10 Case Study: Healing University (p. 93)  CEO, Will Patterson  “We have to define the way we are going to do things, and ensure consistent adherence across the system.” (p. 93)  “The more we can improve the quality of care and do so at a lower cost, the better we will be.” (p. 93)  The Healing Way

13. Slide 13Spring 2014ISE 428 ETM 591 SLH Lean Healthcare Chapter 10 GLOSSARY Stable System (p. 87) A system in which there is a consistent adherence to well-defined policies and procedures

14. Slide 14Spring 2014ISE 428 ETM 591 SLH Lean Healthcare Chapter 10 References / Contact Information Contact Information: Sydney Herrin sydney.l.herrin@gmail.com Dean, M.L. (2013). Lean Healthcare Deployment and Sustainability. New York, NY: McGraw Hill.