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SMART Wheelchair & Seating Kaizen
November 2008
• To identify areas for process improvement
• To Improve patient experience
• Reduce waiting times
• Improve access
• Improve equipment options
Objectives
• Protected time
• Cross-service representation
• Process mapping pre-event
• Day one - extensive workout
– Identify issues using 3 process maps
– Group into common themes
– Identify potential solutions
– Prioritise solutions
Approach
• Days 2 – 4: ‘try storming’
– ‘5S’ in 4 store areas
– Sort, Set in order, Shine, Standardise, Sustain
• Final Day - Action plan
Action Plan
• 28 actions identified– Admin procedures– Patient pathway– Improved use of ReTIS– Stores
• Many actions completed within the week
• Streamlined referral process:
• Goal: Shorter referral – assessment period
• Issues:
– Incomplete referrals
– Separate referrals for each service
– Adult Wheelchair
– Children’s Wheelchair & Seating
– Adult Seating
– Person dependent
Administration Procedures
Actions
• Referral Group
• Number of different referral forms reduced
• Creation of email address
• Access to SCI Gateway
Results
• SMART Referral form
• Single point of contact
• Reduction in incomplete referrals
• Reduction in printing
Patient Pathway
• Creation of combined adult and children power chair clinic
• Children:– Maximum wait reduced from 11-4 weeks
• Adult:– Maximum wait reduced from 8-5 weeks
• One-stop adult clinic re-established due to
modernisation funding
• Chair storage facilitated through 5S
• Many patients attending clinic are receiving a
chair at clinic
– Adult 42%
– Children 20%
Patient Pathway
Improved Use of ReTIS
• ReTIS ‘wish list’
• Standardisation of ReTIS use across services– Adaptations to ReTIS (new job
types, screen appearances etc)– Staff refresher training
• More joined up working
Improved Use of ReTIS
• Accurate data entry of wheelchair stock:
– Chair locations and status in ReTIS ‘untrustworthy’
– Large data cleansing exercise
– New store locations created in ReTIS
• Reduced stock errors
– Quicker patient provision
Improved Use of ReTIS
• Still ‘to do’ list
• ReTIS to be available at point of
wheelchair receipt (remote store)
– Quicker stock availability
• Provision of networked laptops for
domiciliary visits
– More efficient use of staff time
Stores
• 5S in all SMART stores:
– SMART wheelchair (children’s)
– SMART wheelchair (adult)
– SMART main component store
– Livingston main store
• Removal of obsolete / excess equipment
Before
After
During
After
After
Before
After
Livingston – Main Wheelchair Store
• £15K investment in improvements
Overall Summary
• Improved referral to assessment process
• Combined children and adult power chair
clinic
• Re-establishment of one-stop clinic
• Integrated processes across services
• Enhanced team work
Benefits yet to be realised
• Shorter waiting times with:
– Staff recruitment / training
– Release of modernisation funds
• All SMART staff
• ReTIS team
• Lean In Lothian
team
• NHS Lothian
• Edinburgh CHP