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LEA is helping lean pioneers in many sectors 8 years leading proof of concept experiments in healthcare In search of a robust do-it-yourself methodology – which we published Now helping hospitals follow this in the UK, Italy and the USA
Citation preview
Lean Thinking
and Healthcare
Daniel T Jones
Our Journey
LEA is helping lean pioneers in many sectors
8 years leading proof of concept
experiments in healthcare
In search of a robust do-it-yourself
methodology – which we published
Now helping hospitals follow this
in the UK, Italy and the USA
www.leanuk.org
Stable Demand – Created Chaos
Calderdale & Huddersfield NHS Foundation Trust
Variability is
created by the
system
Which means
managing the
system
www.leanuk.org
Attendances
Admitted Patients
Patient Journeys
REHAB
UNIT
HOME
NURSING
HOME
GP
PHARMACY SUPPLIES
PATHOLOGY THERAPIES
EMERGENCY
DEPARTMENT
MAU
SAU
CLINIC
CLINIC
CLINIC
CLINIC
SURGUCAL
WARDS
OPERATING
ROOM
MEDICAL
WARDS
IMAGING
OTHER
WARDS
D
I
S
C
H
A
R
G
E
HOME
NURSING
HOME
www.leanuk.org
Mapping the Patient Journey
6.5 days waiting for 3 hours of work! www.leanuk.org
Visual Hospital Building Blocks
www.leanuk.org
Hospital Level
Visual Hospital
Ward Level
Plan for Every Patient
Plan for Every Support Service
Safety Valve
Replace Top
Management
Write-off Deficits
The Bermuda Triangle
Squeezed
Commissioning
Budgets
Blizzard of
Policies and
Directives
Broken Patient Journey
“We never see Management”
Poor Patient
Experience
Long LOS
Delays
& Queues
everywhere
Silo working &
Unsynchronised
support Poor Operations Management
350 Targets
500 Projects
Many
Meetings
Unfunded
Work
Too many Beds & Staff Big B+A spend
No time for
Improvement
Hospital Management
www.leanuk.org
Focusing on the Vital Few
Reducing Hospital Acquired Infections
Seeing emergency patients within 4 hours
Seeing elective patients within 18 weeks
Reducing length
of stay
Reducing costs
www.leanuk.org
X X X X X X X X X X X X X X R I A I I 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
J F M A M J J A S O N D
Status
On target
Target may be missed
Target 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 Improve Patient Experience X X X X X X X X X X X X X X X X X X
X X X X Improve Teamworking 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 Increased Organisational Research 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
X X X X X X X X X X X X X X X X
X X X Improve Capacity/Demand Understanding X X X X X X X X X X X X X X X X X X
X Negate further T&O Consultant Expansion 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 Achieve full Theatre utilisation at YYF X X X X X X X X X X X X X
X X X X X Produce a 5 year plan for service change X X X X X X X X X X X X
Improve Organisational Learning
Improve Ophthalmology Services
Improve Organisational reflection
Improved Sickness Management
Achieve financial control limit of £2.7m
Optimise workforce levels
Improved DOSA rates of 90%
Improve early finish rates
Achieve UK top quartile day case rates
Improve RTT rates
Improve Trauma Services
Lindse
y
Com
mis
sion Y
YF w
ith a
lloca
ted o
utp
atient ca
paci
ty
5 y
ear
pla
n in p
lace
????
incl
ude c
om
mis
sionin
g a
n S
CCC
Pete
r
Hiro
Julie
P
Ale
d
ach
ieve c
ontr
ol lim
it o
f £2.7
m
To h
ave r
obust
speci
alty d
em
and a
naly
sis
Abolis
h w
aitin
g lis
ts
Halt c
onsu
ltant exp
ansi
on in T
&O
Ach
ieve s
ust
ain
able
work
forc
e levels
Com
mis
sion Y
YF w
ith full
utilis
ation o
f th
eatr
e
Impro
ve s
ickness
managem
ent by h
ow
much
????
What's
the im
pro
vem
ent ta
rget here
????
Ach
ieve D
OSA r
ate
s of 90%
Ach
ieve a
n e
arly fin
ish r
ate
of 10%
Ach
ieve U
K T
op Q
uart
ile for
day c
ase
rate
s
Ach
ieve W
els
h N
ational RTT r
ate
s
Impro
ve the p
atient exp
erience
by h
ow
much
????
Impro
ved team
work
ing b
y h
ow
much
????
Deco
mis
ion 6
bedded T
raum
a b
ay
Ass
ess
or
inst
alle
d u
sing a
modifie
d g
lobal tr
igger
tool
Main
tain
curr
ent co
mpla
int re
sponse
rate
s at above 7
0%
What's
the im
pro
vem
ent ta
rget here
????
RG
H #
NoF m
ort
alit
y r
ate
to top 2
0 p
erc
entile
peer
Reduce
all
Tra
um
a a
ve L
oS b
y 1
5%
Reduce
tim
e to p
roce
dure
for
all
Tra
um
a p
atients
Reduce
#N
oF T
ime to p
roce
dure
to <
24 h
ours
Reduce
#N
oF L
oS b
y ?
?%
Zero
patient si
ght lo
ss d
ue to d
ela
ys
in follo
w u
p
1. Im
pro
ved Q
ualit
y a
nd P
atient Safe
ty
2. In
crease
d O
rganis
ational D
evelo
pm
ent
3. Im
pro
ved P
roce
sses
4. Pla
nnin
g
4. Im
pro
ved F
inanci
al Perf
orm
ance
Management vignettes and research in Div/Dir Meetings
Implement a structured approach to Sickness Management
Research on organisational development
What activities will contribute to this????
What activities will contribute to this other than ours??
Produce a 5 year plan for service change
Lean Trauma Project
Investigate potentially avoidable deaths
Train selected SCD personnel in complaints response
Provide a paper on changes to the Ophthalmology
Implement Tony DiGioia's methodology
Employ Aston Team Working
SCHEDULED CARE DIVISIONAL TARGETS
ACTIVITIES/PROJECTS/EVENTS
AB
HB
OB
JE
CT
IVE
S
IMP
RO
VE
ME
NT
TA
RG
ET
/C
ON
TR
IBU
TIO
N
R = Responsible (Leads/Coaches)A = Accountable (For Delivery)
C = ConsultedI = Involved/Informed
Trust Level Hoshin Check – every 30 days
Site Level Hoshin Check - every 7 days
Site Level Project (Specific) Plans Check - every day
Closed Loop
Deployment
and Feedback
www.leanuk.org
Closed Loop
Deployment
and Feedback Mon
Tue
Wed
Thu
Fri
Sat
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Sun
WHAT WHO
24-N
ov
25-N
ov
26-N
ov
27-N
ov
28-N
ov
29-N
ov
30-N
ov
01-D
ec
02-D
ec
03-D
ec
04-D
ec
05-D
ec
06-D
ec
07-D
ec
08-D
ec
09-D
ec
10-D
ec
11-D
ec
12-D
ec
13-D
ec
14-D
ec
15-D
ec
16-D
ec
17-D
ec
18-D
ec
19-D
ec
20-D
ec
21-D
ec
Identify project lead SG X
Identify project team & roles & responsibilities SG X X X
Establish process for STaR SG X X X
Draw the process for STaR JM X X X
Develop communication plan JM X X X X
Execute communication plan JM X X X X X
Establish skill mix required for STaR IG X
Produce a visual rota for the trial (Medical) SG X X X
Produce a visual rota for the trial (Nursing) IG X X X
Identify risks in each process step (Failure mode effects analysis) JM X X X X X X X
Agree data collection set for trial SG X X X
Plan observational studies of current process CC X
Undertake observational studies CC X
Undertake spaghetti mapping CC X
Analyse all data CC X
Assess whether there needs to be a board outside STaR room IG X
Plan physical changes to department IG X
Complete physical changes to the department JM X X X X X X X X
Clear out STaR room IG X X X
Assess what IT needed for STaR room IG
Assess what equipment is needed for trial IG
Identify any shortfalls in equipment IG
Identify a supply for missing equipment IG
Ensure equipment available for trial IG
Ensure grab board is fitted in cubicles 7 & 8 JM X
Check physical changes to department complete JM X X X X
Ensure defibralator (crash trolley) equipment in place IG X
Implement 5S in STaR room IG
Check all necessary materials are available within the room IG
Check Gratnell trolley/notes IG
Carry out final assessment to ensure that room is safe to use for STaR IG X
Clarify roles and responsibilities IG X
Agree start date for STaR SG X
Go live with STaR trial SG X X X X X X X X X X
Action Plan for STaR (Stream Treat and Refer)
Mon
Tue
Wed
Thu
Fri
Sat
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Sun
WHAT WHO
24-N
ov
25-N
ov
26-N
ov
27-N
ov
28-N
ov
29-N
ov
30-N
ov
01-D
ec
02-D
ec
03-D
ec
04-D
ec
05-D
ec
06-D
ec
07-D
ec
08-D
ec
09-D
ec
10-D
ec
11-D
ec
12-D
ec
13-D
ec
14-D
ec
15-D
ec
16-D
ec
17-D
ec
18-D
ec
19-D
ec
20-D
ec
21-D
ec
Identify project lead SG X
Identify project team & roles & responsibilities SG X X X
Establish process for STaR SG X X X
Draw the process for STaR JM X X X
Develop communication plan JM X X X X
Execute communication plan JM X X X X X
Establish skill mix required for STaR IG X
Produce a visual rota for the trial (Medical) SG X X X
Produce a visual rota for the trial (Nursing) IG X X X
Identify risks in each process step (Failure mode effects analysis) JM X X X X X X X
Agree data collection set for trial SG X X X
Plan observational studies of current process CC X
Undertake observational studies CC X
Undertake spaghetti mapping CC X
Analyse all data CC X
Assess whether there needs to be a board outside STaR room IG X
Plan physical changes to department IG X
Complete physical changes to the department JM X X X X X X X X
Clear out STaR room IG X X X
Assess what IT needed for STaR room IG
Assess what equipment is needed for trial IG
Identify any shortfalls in equipment IG
Identify a supply for missing equipment IG
Ensure equipment available for trial IG
Ensure grab board is fitted in cubicles 7 & 8 JM X
Check physical changes to department complete JM X X X X
Ensure defibralator (crash trolley) equipment in place IG X
Implement 5S in STaR room IG
Check all necessary materials are available within the room IG
Check Gratnell trolley/notes IG
Carry out final assessment to ensure that room is safe to use for STaR IG X
Clarify roles and responsibilities IG X
Agree start date for STaR SG X
Go live with STaR trial SG X X X X X X X X X X
Action Plan for STaR (Stream Treat and Refer)
Mon
Tue
Wed
Thu
Fri
Sat
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Sun
WHAT WHO
24-N
ov
25-N
ov
26-N
ov
27-N
ov
28-N
ov
29-N
ov
30-N
ov
01-D
ec
02-D
ec
03-D
ec
04-D
ec
05-D
ec
06-D
ec
07-D
ec
08-D
ec
09-D
ec
10-D
ec
11-D
ec
12-D
ec
13-D
ec
14-D
ec
15-D
ec
16-D
ec
17-D
ec
18-D
ec
19-D
ec
20-D
ec
21-D
ec
Identify project lead SG X
Identify project team & roles & responsibilities SG X X X
Establish process for STaR SG X X X
Draw the process for STaR JM X X X
Develop communication plan JM X X X X
Execute communication plan JM X X X X X
Establish skill mix required for STaR IG X
Produce a visual rota for the trial (Medical) SG X X X
Produce a visual rota for the trial (Nursing) IG X X X
Identify risks in each process step (Failure mode effects analysis) JM X X X X X X X
Agree data collection set for trial SG X X X
Plan observational studies of current process CC X
Undertake observational studies CC X
Undertake spaghetti mapping CC X
Analyse all data CC X
Assess whether there needs to be a board outside STaR room IG X
Plan physical changes to department IG X
Complete physical changes to the department JM X X X X X X X X
Clear out STaR room IG X X X
Assess what IT needed for STaR room IG
Assess what equipment is needed for trial IG
Identify any shortfalls in equipment IG
Identify a supply for missing equipment IG
Ensure equipment available for trial IG
Ensure grab board is fitted in cubicles 7 & 8 JM X
Check physical changes to department complete JM X X X X
Ensure defibralator (crash trolley) equipment in place IG X
Implement 5S in STaR room IG
Check all necessary materials are available within the room IG
Check Gratnell trolley/notes IG
Carry out final assessment to ensure that room is safe to use for STaR IG X
Clarify roles and responsibilities IG X
Agree start date for STaR SG X
Go live with STaR trial SG X X X X X X X X X X
Action Plan for STaR (Stream Treat and Refer)
X X X X X X X X X X X X X X R I A I I 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
J F M A M J J A S O N D
Status
On target
Target may be missed
Target 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 Improve Patient Experience X X X X X X X X X X X X X X X X X X
X X X X Improve Teamworking 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 Increased Organisational Research 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
X X X X X X X X X X X X X X X X
X X X Improve Capacity/Demand Understanding X X X X X X X X X X X X X X X X X X
X Negate further T&O Consultant Expansion 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 Achieve full Theatre utilisation at YYF X X X X X X X X X X X X X
X X X X X Produce a 5 year plan for service change X X X X X X X X X X X X
Improve Organisational Learning
Improve Ophthalmology Services
Improve Organisational reflection
Improved Sickness Management
Achieve financial control limit of £2.7m
Optimise workforce levels
Improved DOSA rates of 90%
Improve early finish rates
Achieve UK top quartile day case rates
Improve RTT rates
Improve Trauma Services
Lindse
y
Com
mis
sion Y
YF w
ith a
lloca
ted o
utp
atient ca
paci
ty
5 y
ear
pla
n in p
lace
????
incl
ude c
om
mis
sionin
g a
n S
CCC
Pete
r
Hiro
Julie
P
Ale
d
ach
ieve c
ontr
ol lim
it o
f £2.7
m
To h
ave r
obust
speci
alty d
em
and a
naly
sis
Abolis
h w
aitin
g lis
ts
Halt c
onsu
ltant exp
ansi
on in T
&O
Ach
ieve s
ust
ain
able
work
forc
e levels
Com
mis
sion Y
YF w
ith full
utilis
ation o
f th
eatr
e
Impro
ve s
ickness
managem
ent by h
ow
much
????
What's
the im
pro
vem
ent ta
rget here
????
Ach
ieve D
OSA r
ate
s of 90%
Ach
ieve a
n e
arly fin
ish r
ate
of 10%
Ach
ieve U
K T
op Q
uart
ile for
day c
ase
rate
s
Ach
ieve W
els
h N
ational RTT r
ate
s
Impro
ve the p
atient exp
erience
by h
ow
much
????
Impro
ved team
work
ing b
y h
ow
much
????
Deco
mis
ion 6
bedded T
raum
a b
ay
Ass
ess
or
inst
alle
d u
sing a
modifie
d g
lobal tr
igger
tool
Main
tain
curr
ent co
mpla
int re
sponse
rate
s at above 7
0%
What's
the im
pro
vem
ent ta
rget here
????
RG
H #
NoF m
ort
alit
y r
ate
to top 2
0 p
erc
entile
peer
Reduce
all
Tra
um
a a
ve L
oS b
y 1
5%
Reduce
tim
e to p
roce
dure
for
all
Tra
um
a p
atients
Reduce
#N
oF T
ime to p
roce
dure
to <
24 h
ours
Reduce
#N
oF L
oS b
y ?
?%
Zero
patient si
ght lo
ss d
ue to d
ela
ys
in follo
w u
p
1. Im
pro
ved Q
ualit
y a
nd P
atient Safe
ty
2. In
crease
d O
rganis
ational D
evelo
pm
ent
3. Im
pro
ved P
roce
sses
4. Pla
nnin
g
4. Im
pro
ved F
inanci
al Perf
orm
ance
Management vignettes and research in Div/Dir Meetings
Implement a structured approach to Sickness Management
Research on organisational development
What activities will contribute to this????
What activities will contribute to this other than ours??
Produce a 5 year plan for service change
Lean Trauma Project
Investigate potentially avoidable deaths
Train selected SCD personnel in complaints response
Provide a paper on changes to the Ophthalmology
Implement Tony DiGioia's methodology
Employ Aston Team Working
SCHEDULED CARE DIVISIONAL TARGETS
ACTIVITIES/PROJECTS/EVENTS
AB
HB
OB
JE
CT
IVE
S
IMP
RO
VE
ME
NT
TA
RG
ET
/C
ON
TR
IBU
TIO
N
R = Responsible (Leads/Coaches)A = Accountable (For Delivery)
C = ConsultedI = Involved/Informed
X X X X X X X X X X X X X X R I A I I 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
J F M A M J J A S O N D
Status
On target
Target may be missed
Target 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 Improve Patient Experience X X X X X X X X X X X X X X X X X X
X X X X Improve Teamworking 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 Increased Organisational Research 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
X X X X X X X X X X X X X X X X
X X X Improve Capacity/Demand Understanding X X X X X X X X X X X X X X X X X X
X Negate further T&O Consultant Expansion 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 Achieve full Theatre utilisation at YYF X X X X X X X X X X X X X
X X X X X Produce a 5 year plan for service change X X X X X X X X X X X X
Improve Organisational Learning
Improve Ophthalmology Services
Improve Organisational reflection
Improved Sickness Management
Achieve financial control limit of £2.7m
Optimise workforce levels
Improved DOSA rates of 90%
Improve early finish rates
Achieve UK top quartile day case rates
Improve RTT rates
Improve Trauma Services
Lindse
y
Com
mis
sion Y
YF w
ith a
lloca
ted o
utp
atient ca
paci
ty
5 y
ear
pla
n in p
lace
????
incl
ude c
om
mis
sionin
g a
n S
CCC
Pete
r
Hiro
Julie
P
Ale
d
ach
ieve c
ontr
ol lim
it o
f £2.7
m
To h
ave r
obust
speci
alty d
em
and a
naly
sis
Abolis
h w
aitin
g lis
ts
Halt c
onsu
ltant exp
ansi
on in T
&O
Ach
ieve s
ust
ain
able
work
forc
e levels
Com
mis
sion Y
YF w
ith full
utilis
ation o
f th
eatr
e
Impro
ve s
ickness
managem
ent by h
ow
much
????
What's
the im
pro
vem
ent ta
rget here
????
Ach
ieve D
OSA r
ate
s of 90%
Ach
ieve a
n e
arly fin
ish r
ate
of 10%
Ach
ieve U
K T
op Q
uart
ile for
day c
ase
rate
s
Ach
ieve W
els
h N
ational RTT r
ate
s
Impro
ve the p
atient exp
erience
by h
ow
much
????
Impro
ved team
work
ing b
y h
ow
much
????
Deco
mis
ion 6
bedded T
raum
a b
ay
Ass
ess
or
inst
alle
d u
sing a
modifie
d g
lobal tr
igger
tool
Main
tain
curr
ent co
mpla
int re
sponse
rate
s at above 7
0%
What's
the im
pro
vem
ent ta
rget here
????
RG
H #
NoF m
ort
alit
y r
ate
to top 2
0 p
erc
entile
peer
Reduce
all
Tra
um
a a
ve L
oS b
y 1
5%
Reduce
tim
e to p
roce
dure
for
all
Tra
um
a p
atients
Reduce
#N
oF T
ime to p
roce
dure
to <
24 h
ours
Reduce
#N
oF L
oS b
y ?
?%
Zero
patient si
ght lo
ss d
ue to d
ela
ys
in follo
w u
p
1. Im
pro
ved Q
ualit
y a
nd P
atient Safe
ty
2. In
crease
d O
rganis
ational D
evelo
pm
ent
3. Im
pro
ved P
roce
sses
4. Pla
nnin
g
4. Im
pro
ved F
inanci
al Perf
orm
ance
Management vignettes and research in Div/Dir Meetings
Implement a structured approach to Sickness Management
Research on organisational development
What activities will contribute to this????
What activities will contribute to this other than ours??
Produce a 5 year plan for service change
Lean Trauma Project
Investigate potentially avoidable deaths
Train selected SCD personnel in complaints response
Provide a paper on changes to the Ophthalmology
Implement Tony DiGioia's methodology
Employ Aston Team Working
SCHEDULED CARE DIVISIONAL TARGETS
ACTIVITIES/PROJECTS/EVENTS
AB
HB
OB
JE
CT
IVE
S
IMP
RO
VE
ME
NT
TA
RG
ET
/C
ON
TR
IBU
TIO
N
R = Responsible (Leads/Coaches)A = Accountable (For Delivery)
C = ConsultedI = Involved/Informed
X X X X X X X X X X X X X X R I A I I 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
J F M A M J J A S O N D
Status
On target
Target may be missed
Target 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 Improve Patient Experience X X X X X X X X X X X X X X X X X X
X X X X Improve Teamworking 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 Increased Organisational Research 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
X X X X X X X X X X X X X X X X
X X X Improve Capacity/Demand Understanding X X X X X X X X X X X X X X X X X X
X Negate further T&O Consultant Expansion 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 Achieve full Theatre utilisation at YYF X X X X X X X X X X X X X
X X X X X Produce a 5 year plan for service change X X X X X X X X X X X X
Improve Organisational Learning
Improve Ophthalmology Services
Improve Organisational reflection
Improved Sickness Management
Achieve financial control limit of £2.7m
Optimise workforce levels
Improved DOSA rates of 90%
Improve early finish rates
Achieve UK top quartile day case rates
Improve RTT rates
Improve Trauma Services
Lindse
y
Com
mis
sion Y
YF w
ith a
lloca
ted o
utp
atient ca
paci
ty
5 y
ear
pla
n in p
lace
????
incl
ude c
om
mis
sionin
g a
n S
CCC
Pete
r
Hiro
Julie
P
Ale
d
ach
ieve c
ontr
ol lim
it o
f £2.7
m
To h
ave r
obust
speci
alty d
em
and a
naly
sis
Abolis
h w
aitin
g lis
ts
Halt c
onsu
ltant exp
ansi
on in T
&O
Ach
ieve s
ust
ain
able
work
forc
e levels
Com
mis
sion Y
YF w
ith full
utilis
ation o
f th
eatr
e
Impro
ve s
ickness
managem
ent by h
ow
much
????
What's
the im
pro
vem
ent ta
rget here
????
Ach
ieve D
OSA r
ate
s of 90%
Ach
ieve a
n e
arly fin
ish r
ate
of 10%
Ach
ieve U
K T
op Q
uart
ile for
day c
ase
rate
s
Ach
ieve W
els
h N
ational RTT r
ate
s
Impro
ve the p
atient exp
erience
by h
ow
much
????
Impro
ved team
work
ing b
y h
ow
much
????
Deco
mis
ion 6
bedded T
raum
a b
ay
Ass
ess
or
inst
alle
d u
sing a
modifie
d g
lobal tr
igger
tool
Main
tain
curr
ent co
mpla
int re
sponse
rate
s at above 7
0%
What's
the im
pro
vem
ent ta
rget here
????
RG
H #
NoF m
ort
alit
y r
ate
to top 2
0 p
erc
entile
peer
Reduce
all
Tra
um
a a
ve L
oS b
y 1
5%
Reduce
tim
e to p
roce
dure
for
all
Tra
um
a p
atients
Reduce
#N
oF T
ime to p
roce
dure
to <
24 h
ours
Reduce
#N
oF L
oS b
y ?
?%
Zero
patient si
ght lo
ss d
ue to d
ela
ys
in follo
w u
p
1. Im
pro
ved Q
ualit
y a
nd P
atient Safe
ty
2. In
crease
d O
rganis
ational D
evelo
pm
ent
3. Im
pro
ved P
roce
sses
4. Pla
nnin
g
4. Im
pro
ved F
inanci
al Perf
orm
ance
Management vignettes and research in Div/Dir Meetings
Implement a structured approach to Sickness Management
Research on organisational development
What activities will contribute to this????
What activities will contribute to this other than ours??
Produce a 5 year plan for service change
Lean Trauma Project
Investigate potentially avoidable deaths
Train selected SCD personnel in complaints response
Provide a paper on changes to the Ophthalmology
Implement Tony DiGioia's methodology
Employ Aston Team Working
SCHEDULED CARE DIVISIONAL TARGETS
ACTIVITIES/PROJECTS/EVENTS
AB
HB
OB
JE
CT
IVE
S
IMP
RO
VE
ME
NT
TA
RG
ET
/C
ON
TR
IBU
TIO
N
R = Responsible (Leads/Coaches)A = Accountable (For Delivery)
C = ConsultedI = Involved/Informed
Strategy Deployment
Escaping the Bermuda Triangle
Vital Few
Objectives
Departmental
Contributions
Escalate
Problems
Quickly
Aligned &
Resourced
Projects
Synchronise Support Services
Visual
Hospital
Plan For Every Patient No Delays
Or Queues Right LOS
www.leanuk.org
Work with
Commissioners to
align Demand with
Capacity and
eliminate
Waste
Stop the
Blizzard of
Directives
HSJ Best Acute Hospital 2010
£2.2 m savings from
closing 100 medical beds
50% reduction in
Bank and Agency spend
No compulsory redundancies
Calderdale & Huddersfield
NHS Foundation Trust
Shortest Length of Stay
No increased readmissions
Continuing to improve
www.leanuk.org
Lean Thinking
and Healthcare
from www.leanuk.org
and Amazon Kindle
Recommended