LEAN on the OR VU University Medical center
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This document discusses introducing lean culture and principles to improve operating room efficiency. It notes that lean can help by focusing on patient value, eliminating waste, improving employee engagement, optimizing OR resource use, streamlining processes, and standardizing practices. A lean introduction team is formed to pilot lean in specific areas like the sterilization department and day surgery. The team will create value stream maps, key performance metrics, and teach lean principles like measuring metrics visually, daily stand-up meetings, problem solving in autonomous teams, and establishing standards. The goal is to reduce the number of canceled elective surgeries each day by addressing the various reasons for cancellation.
LEAN on the OR VU University Medical center
- 1. Lean culture to improve operating room ef鍖ciency 21th september 2011
- 2. 2007 operating room 鍖r艶
- 3. 2010
- 5. Safetymanagement Qualitymanagement Passport NIAZ
- 6. Under- and overuse of OR resources
- 7. Gap between planning and reality
- 8. OR cancellations of elective operations
- 10. Why also LEAN in our operating rooms ? 1. Focus on the patient, focus on value 2. Decrease waste (waiting, transportation, overproduction, overstocking) 3. Improve employee engagement and satisfaction 4. Improved OR use: decrease in under- and overuse of OR resources 5. Streamlining the pre-, intra- and postoperative process 6. Reducing OR nonoperative time (turnover times, waiting times) 7. Process standardization
- 11. LEAN introduction team Kjeld Aij, head operating rooms Ellen Duijnhouwer, lean coach Marjolijn Jungman, lean coach Stephan Loer, head anesthetic department Arnoud Orelio, lean coach Peter Veerman, medical head operating rooms
- 12. LEAN Pilot operating room Sterilization department Acute operations Daysurgery ENT-daysurgery
- 13. Value stream map
- 15. Invoeringsteam lean op OK - KPI 2: aantal afgezegde electieve operaties per dag Kleurcodes reden afzegging: norm AOZ (blauw) wk 10-25: 4x SNIJDER (rood) wk 10-25: 98x PATIENT (groen) wk 10-25: 67x GEEN IC/MC (zwart) wk 10-25: 31x week ma di wo do vr totaal week 24: 13-6 X II IIII IIIII IIIII 16 week 25: 20-6 III II I II IIIII 13 week 26: 27-6 week 27: 4-7 week 28: 11-7 week 29: 18-7
- 16. Teaching principles of LEAN 1: Metingen! ! WSA! ! KPI de鍖nitie! ! KPI兵s meten! KPI bord! ! Visueel! ! Door het team! 5: Standaarden! 2: Stand-up! ! Vastleggen, visuali- ! Team rapporteert! seren & veri鍖谷ren! Continu ! Interactie team/ ! Trainen! manager! verbeteren ! Verbeterd!! met betrokken ! De鍖nieer/ Stand-up! rapporteer acties! mensen! top 3! 4: Oplossingen! 3: Problemen ! ! Gestructureerd! ! Detectie/identi鍖catie! ! In autonome teams! ! Communicatie! ! Bronoorzaken ! Op basis van feiten! Verbeter(team)! bepalen en ! Onder controle bord! oplossen! brengen/ isoleren! 16
- 18. Bijlage 2
- 19. Canceled procedures !15-16 ORs !Time: 8 a.m. - 15.45 p.m. !Capacity off-hours 4 - 2 ORs
- 20. Canceled procedures !Every day 4 p.m. !Coordinators and OR management !Planning staff general surgery !.....
- 21. Invoeringsteam lean op OK - KPI 2: aantal afgezegde electieve operaties per dag # afgezegde electieve operaties per week 19 18 17 Kleurcodes reden afzegging: 16 15 14 13 norm 12 11 AOZ (blauw) wk 10-25: 4x 10 9 8 7 6 5 SNIJDER (rood) wk 10-25: 98x 4 3 2 1 0 PATIENT (groen) wk 10-25: 67x 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 GEEN IC/ weeknr MC (zwart) wk 10-25: 31x # afgezegde electieve operaties norm (nog te bepalen) week ma di wo do vr totaal week 24: X II IIII IIIII IIIII 16 13-6 week 25: III II I II IIIII 13 20-6 week 26: 27-6 week 27: 4-7
- 22. Canceled procedures !AOZ 10 % !Patient 25 % !Surgical/scheduling 65 %
- 23. Canceled procedures !Difficult to determine root cause "Even coordinators dont know !Reasons very divers !Information dissapears rapidly !Not perceived as problem
- 25. Why get LEAN? Productivity improvements of 20-50% Set-up time reductions of 60-80% Inventory reductions of 40-75% Floor space reductions of 30-50% Reduced quality defects by 50-100% Improved safety performance of 30-60% More ef鍖cient procedures Survival in the marketplace
- 27. Surgery is a complex process where many resources act together
- 32. Lean lessons learned... Getting lean takes a long time Lean is not a part-time effort Lean is more than tools, its also behavior The journey to lean never ends There will be resistance to lean within the organization
- 33. Keys to LEAN leadership Gothe production鍖oor (gemba) time on See--senior leaders must spend Ask day to uncover the root cause times every Why--use the question many Show Respect--respect employees, suppliers, and customers
- 37. Lean lessons from others The top leaders need to lead lean Be prepared for the front-end investment Lean is not just for manufacturing There is a lean roadmap, but no lean cookbook You cannot just copy another lean organizations journey
- 38. Next steps Business Assessment Call to Action and Commitment Align with Policy Deployment Training and/or Sensei Resource Allocation Process Selection Begin the Journey Implement New Metrics Review Progress and Adjust as Needed
- 39. You mustTRANSFORM the organization to avoid snap- backto the old ways or dont even bother to start.