PRACTICING LEAN

Bad News Good News

Daniel T Jones

Lean uses the same scientific approach

to diagnose and treat organisational problems

as doctors use to solve

medical problems

Its Product + Service + User Experience

Big Data + users Gemba

Better + Faster + Simpler

Value Streams = the sum of the capabilities of the line

Ability to See & to Act

Supported by Coaches with Experience

Google changes the role of Experts

Support activities in the line

Learn to Pull before you Automate

Simpler Systems & Compressed Supply Chains

Some Decisions are too important to Computerise

A M J J A S O N D J F M

X X X X X X Visual Hospital X X X X X X X X X X X X X

X X X X X X X X X X X X X X X X X X X X X X X X

X X X X Integrated 7 day working at back door X X X X X X X X X X X

X X X X X X X X X X X X X X X X X

X X X X X X X X X X X X X X X X X X X X X X

X X X X X X X Pathway redesign X X X X X X X X X X X X X X X X X X X

X X X X X Theatre utilisation X X X X X X X X X X X X X X X

X X X X Endoscopy utilisation X X X X X X X X X X X X X X

X X X X X X X X X X X X X X

On Target

Not on Target or Missed

X X X X X X X X X X

X X X X X X X X X X X

X X X X X X X X X X X X

X X X X X

X X X X X X X

X X X X X X X X X

X X X X X X X X X X

X X X X X X X 061011 version 9

Release 9438 bed days in surgery

Release 24627 bed days in medicine

Release of 735 OPD clinics

Reduction of 1993 readmissions

Integrated Urgent Care Centres to release 2393 bed days

Increase of 96 day cases

Imple

menta

tion o

f U

rgent Care

Sta

ndard

s

OPD new/ F/U ratio

Imple

menta

tion o

f Pla

nned C

are

Sta

ndard

s

Fin

anci

al Bala

nce

Impro

ved T

heatr

es

/Endosc

opy U

tilis

ation

Redesi

gn o

f fr

ont door

Length

of Sta

y R

educt

ion

Impro

ved a

ccess

to p

lanned c

are

- O

PD

& d

iagnost

ics

15%

reduct

ion in s

urg

ical le

ngth

of st

ay

Reduce

bed o

ccupancy

to 9

5%

Transformation Deployment Matrix - Work Streams - Trust Level 2011/12

Integrated Urgent Care Centre

Plan for Every Patient

Senior daily review

Increase of 86 lists in endoscopy

Potential efficiency equal to 4221 cases in theatres

15%

reduct

ion in e

merg

ency

medic

al le

ngth

of st

ay

Pla

nned C

are

Acc

ess

- H

eath

er

Cart

er

Theatr

es

& E

ndosc

opy -

Heath

er

Cart

er

Urg

ent Care

Acc

ess

Anne S

ym

on

50%

reduct

ion in o

n the d

ay c

ance

llations

Length

of Sta

y -

David

Furley

Readm

issi

ons

within

30 d

ays

- 25%

reduct

ion

25%

reduct

ion tow

ard

s 08/0

9 a

dm

issi

ons

levels

in E

D

Incr

ease

day c

ase

rate

by 2

5%

for

sele

ct c

onditio

ns

Incr

ease

theatr

e u

tilis

ation to 8

5%

Incr

ease

dis

charg

e r

ate

to m

eet ta

kt 7 d

ays

Incr

ease

endosc

opy u

tilis

ation to 9

2%

Ach

ieve 2

5%

reduct

ion in O

utp

atient fo

llow

ups

15%

reduct

ion in L

oS for

5 a

mbula

tory

path

ways

TRAN

SFO

RM

ATIO

N P

RIO

RIT

IES

TIMELINE

TTT

TARGETSTARGETS

PROJECTS

TTT

PROJECT DELIVERABLES

TOP

LEV

EL M

ETR

ICS

Dialogue to frame questions and agree actions

Engage Users in Designing the Future

3P saves Capital & running Costs

Relentless disruptive technology push

Depends on social organisations to make it happen

Potential to deskill many types of jobs

Rather than creating fulfilling work

Big data can spot trends and act

Before understanding cause and effect

PRACTICING LEAN

@DanielJonesLean www.leanuk.org