1. Steve Peirce, CMQ/OE Director, Process Excellence, Alberta Health Services Lean in Health Care

2. Healthcare – The Perfect Storm CRA 2012 Preliminary Statistics Statistics Canada – Population Estimates and Projections – Medium Growth Model Statistics Canada 2009 – 2014 health Care Services

3. What is the Problem? Capacity? Resources? Priorities?

4. Is Lean the Answer?

6. 1. Identify Value Source: Health Quality Council of Alberta

7. 2. Map the Value Stream …. To Manage Capacity Demand 2 min 60 min 120 min 30 min Activities Waits Capacity (Constraint)

8. 3. Create Flow …. To Obtain Resources

9. 4. Establish Pull…. To Create Capacity Takt time = 2 min Task 1Task 2Task 3Task 4Task 5 “Bottleneck” Time to Do Each Task (seconds) 0 30 60 90 12 0 Task 1Task 2Task 3Task 4Task 5 Eliminate “Bottleneck” More capacity! Time to Do Each Task (seconds) 0 3030 6060 9090 120120 Takt time = 2 min Source: Alberta Health Services Improvement Way Schedule WorkDemand

10. 5. Seek Perfection…. To Set Priorities Source: Lean Enterprise Institute, Cambridge Mass

11. Standard Work…. To Sustain … and improve Level 4 Improvement based on Scientific Method

12. Lean Transformation System Value Driven Purpose Situational Purpose (Target Condition) True North Q1. What problem are we trying to solve? Process Improvement Six Sigma, Lean, AIW Capacity Development Yellow /Green /Black Belt Basic Thinking, mindsets, assumptions: Professional Practice, Complex Systems, PDSA, Evidence Based Q2: How will we change the work? Q3. How will we develop the people? Management System Leadership Behaviours Q4. What leader behaviours and Management System is required? Q5: What basic thinking (mindset? Assumptions) underlie / drive this transformation ? Source: Lean Enterprise Institute, Cambridge Mass

13. Alberta Health Services Improvement Way Source: Alberta Health Services Fundamentals of Improvement, Change and Problem Solving Describe the problem, opportunity and goal, confirm as a priority and link to AHS Strategic Goals Validate opportunity, baseline performance, use facts/data to pinpoint waste, variation, root causes, design criteria Develop, test, measure & refine changes; manage risks; confirm achievement of intended outcome(s) Ensure: ongoing measures & monitoring; capacity to support new practices; accountability & support

14. Alberta Health Services Improvement Way Source: Alberta Health Services Fundamentals of Improvement, Change and Problem Solving

15. Steve Peirce Director, Process Excellence Corporate Services, Alberta Health Services steve.peirce@ahs.ca