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Introduction to Lean
Lean is a systematic approach to identifying and eliminating waste through continuous improvement. • Key principles
– Value is in the eyes of the customer – Make value flow without interruptions
• Improve work flow • Standardize work processes
– Pursue perfection
• 7 wastes – Overproduction – Excess motion – Waiting – Inventory – Defect correction – Over processing – Lost creativity/talent
• Common Lean Tools
– Process Map
Title: Asthma Triage Process Map
Triage Nurse
Prim
ary Nurse
Reside
nt/PA/NP/
Stud
ent
Attend
ing MD
Phase: Initiation of Treatment
Patient unassigned provider
Assigned
Assigned
Assigned
Based on patient load, zone staffing
Primary Assessment (PASS)Low Acuity Data entry
Primary Assessment
Discussion of Patient
Order for Tx
Verbal request for Meds
High Acuity
Primary Assessment
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– Value Stream Map
– Spaghetti Diagram
3
– Pareto Chart
– Fishbone Diagram
– Poka-‐Yoke (error proofing) http://www.thetoyotasystem.com/lean_inventions/poka_yoke-‐you-‐can%E2%80%99t-‐go-‐wrong.php
49 24
17
4 4 3 0 0 0 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
0
20
40
60
80
100
CumulaS
ve Percentage
Num
ber o
f Events
Hospital Acquired CondiSons
Hospital Acquired CondiSons Jan 2011 -‐ August 2012
4
– 5S
The content included in this document is provided as a brief overview of Lean concepts. Numerous websites and texts are available that provide additional information about Lean. Christine M. Walsh-‐Kelly MD 5-‐19-‐2014