Lean Design for Hospitals

Enabling clinicians to deliver better patient care by eliminating wasteful activities.

 
   
   

 

 

 

Design Future Space

Design Future Space

Improve Current Space

Improve Current Space

Bring Improvements Live

Bring Improvements Live

Get Started Today!

Get Started Today!

Contact Gerard Leone, Principal of Lean Hospital Practice, directly to find out how we can assist your Lean Hospital Design efforts.

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

The Benefits of
Designing a Lean Hospital

Reduced Space Requirements

Reduced Space Requirements

Improved On-Time Starts

Improved On-Time Starts

Reduced Inventory of Medical Supplies

Reduced Inventory of Medical Supplies

Predictable Patient Flow

Predictable Patient Flow

Predictable Staff Requirements

Predictable Staff Requirements

Shorter Response Time to Emergencies

Shorter Response Time to Emergencies

Improved Quality of Care

Improved Quality of Care

Fully incorporated Lean principles

Fully incorporated Lean principles

The Design Process

Develop the future state design for the critical value streams that shape the new space.

Current State Value Stream Map

Current State Value Stream Map

We use the Value Stream Mapping technique for its ability to capture processing times as well as delay times. We start by mapping the current state of the value stream, warts and all. From this work, two main categories of improvements will surface.

Identify and Document Phase II Improvements

Identify and Document Phase II Improvements

These are process improvement ideas that, while important, are not likely to impact the physical aspects of the Future Space. It will be up to Hospital Leadership to decide when these are to be tackled.

Improve with Lean Tools

Improve with Lean Tools

Between the time the design for the Future Space and the day when the space is brought live, there will be a list of continuous improvement ideas that must be worked on. Many of them will improve the performance of the current space and that improved performance will carry.

Identify and Document New Space Process Improvements

Identify and Document New Space Process Improvements

These are process improvement ideas that will help shape the Future Space, from the location of Inventory to the parking of Patient beds and Wheelchairs.

Design New Processes

Design New Processes

In many cases some of the proposed processes do not exist and must be designed. One example is the picking and delivering of case carts based on OR demand rather than batching. The number of spaces must be calculated and processes steps have to be carefully documented to ensure flawless performance.

Future State Value Stream Map

Future State Value Stream Map

This version of the Value Stream Map will be prepared as a way to look into the future to understand the improved performance.

The Design Process

Develop the future state design for the critical value streams that shape the new space.

  • Current State Value Stream Map

    Current State Value Stream Map

    We use the Value Stream Mapping technique for its ability to capture processing times as well as delay times. We start by mapping the current state of the value stream, warts and all. From this work, two main categories of improvements will surface.

  • Identify and Document Phase II Improvements

    Identify and Document Phase II Improvements

    These are process improvement ideas that, while important, are not likely to impact the physical aspects of the Future Space. It will be up to Hospital Leadership to decide when these are to be tackled.

  • Improve with Lean Tools

    Improve with Lean Tools

    Between the time the design for the Future Space and the day when the space is brought live, there will be a list of continuous improvement ideas that must be worked on. Many of them will improve the performance of the current space and that improved performance will carry.

  • Identify and Document New Space Process Improvements

    Identify and Document New Space Process Improvements

    These are process improvement ideas that will help shape the Future Space, from the location of Inventory to the parking of Patient beds and Wheelchairs.

  • Design New Processes

    Design New Processes

    In many cases some of the proposed processes do not exist and must be designed. One example is the picking and delivering of case carts based on OR demand rather than batching. The number of spaces must be calculated and processes steps have to be carefully documented to ensure flawless performance.

  • Future State Value Stream Map

    Future State Value Stream Map

    This version of the Value Stream Map will be prepared as a way to look into the future to understand the improved performance.

Critical Value Streams

The value streams that are likely to shape the Future Space are:

Patient Flow

Every Hospital we know and have worked with has Patient Flow problems that are reflected in the Patient Satisfaction Scores and on Physician efficiency. Patient Flow is the Value Stream that we pay the most attention to. We not only Map the Value Stream, but also define Process Flow Diagrams for every Patient category.

Patient Conveyance

Patients are, in many cases, moved from one area to another using some kind of conveyance device, from stretchers to Isolettes. Failing to account for patient conveyance in the design, results in loss of time “hunting” for the device as well as a general disorganization in the area (messy aisles and alcoves).

Equipment Flow

We see this time and again: Everybody is ready in the OR but the C-Arm is nowhere to be found. Why? Because equipment flow was not designed into the Future Space so the C-Arm or the Wilson table are store in a different place (more like thrown in a different place) after every procedure.

Case Kitting

The Case Carts are in most cases assembled in large batches that force the Architects to designate large spaces to hold idle case carts that will wait for 12 or 18 hours before anybody places their hands upon them, generating waste all around.

Instrument Set Flow

Instrument sets must arrive to the OR when needed and no later. To do so, they must leave the OR on time and in the right condition and arrive to the Sterile Processing in a time no lonhger than the actual transportation time.

Emergency Sets

The storage, retrieval, use, re-processing, and re-storage must be designed into the Future Space to maximize Clinician’s efficiency and Patient Care.

Materials Management

Hospital Materials Management practices vary from poor to appalling. When Architects are forced to design around those processes, Clinicians end up with more of the same: constant hunting and wasting of time looking for medical supplies, just in a nicer-looking space.

Refuse Management

The day I saw en Environmental Services employee dragging a trash bag out of an OR will forever be etched in my memory.

Vendor Instrument Sets

Left to their own devices, Vendors will drop instrument trays anywhere and run to the next hospital. With careful design, there is no need to ask where is the Total Knee Tray because it is always in the same place that was designed for it.

Get Started Today!

Get Started Today!

Contact Gerard Leone, Principal of Lean Hospital Practice, directly to find out how we can assist your Lean Hospital Design efforts.

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

The Lean Hospital Design Roadmap

How it Works:

In order to successfully complete a Lean Hospital Design project, it's important to have a proven series of steps to document the process. We call that our Lean Hospital Design Roadmap. It's an excellent jumping off point. We'll start with the steps that are proven to work then work with you to customize our process to meet your needs and solve any pain points that you are having.

Lean Hospital Design Roadmap

Breaking Down The Roadmap
Step-by-Step

Define Target Departments

Define Target Departments

A hospital is a complex web of Units, Departments, and Support Entities. Pain points in the design must be clearly documented, so the Value Streams that affect those departments can be mapped.

Assess Current Performance

Assess Current Performance

What is good, what is great, and what needs improvement in the target areas as they stand today?

Align with Hospital Goals

Align with Hospital Goals

It is not uncommon to see Metric sets that do not align with the Hospital/System Goals or even its Strategic Pillars. New metrics may be defined and old ones discontinued. We are also looking to measure the success of the Future Space.

Define Critical Value Streams

Define Critical Value Streams

Define Value Streams that are the most likely to affect the design of the Future Space. The selected Value Streams will cover everything from Patient Flow to Case cart Picking to Staging.

Current Critical State Value Stream Mapping

Current Critical State Value Stream Mapping

All critical value streams are mapped and all opportunities for improvement are documented and categorized. At this point in the process, you will also begin tracking improvements by creating a Continuous Improvement Database.

Log Improvements Database

Log Improvements Database

Start building the Continuous Improvement Database by logging improvement ideas that impact the design of the Future Space. These processes will provide the Architects with the best information for their physical design.

Log Phase II Improvements Database

Log Phase II Improvements Database

The second batch of improvement ideas are not likely to impact the design of the Future Space, but must be worked on in the intervening time between the end of the design and the cutting of the ribbon for the Future Space, so that they're ready to be implemented as soon as they are needed.

Design Future Critical Value Streams

Design Future Critical Value Streams

With the current state documented and the improvement opportunities logged, we turn our attention to optimizing critical value streams and developing standard processes and procedures that will make their performance predictable and sustainable.

Document Future Procedures

Document Future Procedures

Every last procedure is documented using Standard Work documentation. Whenever training is necessary, training materials are developed and deployed.

Identify Space Requirements

Identify Space Requirements

For every process, a space requirement is developed and/or calculated.

Review Space Requirements with Architects

Review Space Requirements with Architects

Every proposed space requirement is evaluated as a team with the Architects leading the review. A feedback loop for re-defining the spaces is put in place.

Fine Tune and Document

Fine Tune and Document

All spaces are documented and provided to the Architects to put together the physical design. This will be an iterative process with several reviews and corrections.

Deliverables

Our goal is not to make you “consulting junkies”, quite the opposite. Our Lean Hospital strategy contains a clear exit strategy for your consulting help, once you’ve developed the internal capabilities and systems to continue upwards on your own.

Improvement Database

Typically, dozens of improvement opportunities are identified during the project. These ideas will be the foundation of your Kaizen program.

Current State Value Stream Maps for Critical Value Streams

An unbiased analysis of the way work is currently performed, on the most important work flows that impact your patients.

Future State Value Stream Maps for Critical Value Streams

The start-to-finish flow chart of the most important work flows, and the foundation for your Lean Hospital Design.

Future State Procedures

Without standardization there can be no improvement. Create user-friendly procedures for all critical processes.

Get Started Today!

Get Started Today!

Contact Gerard Leone, Principal of Lean Hospital Practice, directly to find out how we can assist your Lean Hospital Design efforts.

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.