Developing a Culture of Continuous Improvement

Australian Red Cross Blood Service - Brisbane Processing Centre

Presented by;

Josh Duncan & Joe Patkes March 2016

Presentation Outline

The Blood Service

Early CIWhere to now?

What We Do & Who We Are?

Suppliers of blood and blood products

States and Territories /

Commonwealth Governments Standing Council on Health (SCoH)

Jurisdictional Blood Committee (JBC)Membership comprise Commonwealth, State and Territory

Ministers with responsibility for health matters

National Blood Authority (NBA)

Suppliers of fractionated components

Corporate Strategy & Performance

Medical, Transplantation & Quality Services

Donor Services

Manufacturing

Supply Chain

PatientDonor

Finance, HR, R&D, IS

We are organised pretty similar to most Manufacturing

businesses…

With a few key differences

OUR RAW MATERIAL

OUR CUSTOMERS

OUR PRODUCTS

• We rely on voluntary blood donors as our raw

material

• We need to market to our donors as if they are

customers

• Recipients of our products, patients, are by

definition vulnerable

• They do not generally make the buying decision

• Our products are supplied free at the point of

sale

• We collaborate with governments and clinicians

to minimise use of our products

Type of Blood Donations

Post Donation – Whole Blood

Post Donation – Apheresis Plasma & Platelets

What Blood Products Do? Red Cells

The main function of these cells is to carry oxygen from the lungs to all the cells of the body and remove

waste products such as carbon dioxide.

Plasma

It is the straw coloured fluid in which the red cells, white cells and platelets are suspended. It contains

very important nutrients and clotting factors which help to prevent or stop bleeding.

Platelets

Platelets assist in the blood clotting process. They are literally tiny plates that wedge together covering

tears in the blood vessels and preventing blood from leaking into surrounding tissue.

Platelets are used primarily in the treatment of people with various cancers. Diseases such as leukaemia

and medical treatments like chemotherapy can decrease a person's platelet count.

Blood Product Supply Chain Overview

BL

OO

D S

ER

VIC

E

Blood Collections

Processing &

Testing

Customer Service

and Order

Fulfilment

Hospitals

Donors Approximately 500,000 unpaid donors

Approx.150 hospitals (excludes a number of minor clinics)

10 depots – 5 at processing centres (Melbourne, Sydney, Brisbane,

Perth and Darwin) and 5 more (Canberra, Adelaide, Townsville,

Hobart and Cairns)

5 processing centres in Melbourne, Sydney, Brisbane, Perth and

Darwin (there is no testing in Darwin)

30 mobile collection

units

78 static

collection units

Inventory is held at our main

processing centres (red) and at

strategically located depots (black)

2015

Drivers for Lean

Expects adequate, safe and secure supply of blood products

Expects us to use its funding wisely on behalf of taxpayers

Judges our performance against that of our peers

• Can meet the Government’s expectations

• Meet the needs of the patients who rely on us

• Honour the contribution of our donors

Our Government:

By embracing lean methodologies:

Lean Journey 2011 – 2014

Manufacturing Identity

Launched

First rollout Lean

Practitioner Training

Lean Awareness for Manufacturing

Supervisors

Lean Leadership – Manufacturing, Donor Services, HR, Corporate and Strategy

May

11

May

12

Aug

12

Apr

13

Nov

13

Mar

14

Apr

14

May

14

Aug

14

Manufacturing Division Created

National Lean Manufacturing Team Created

Regional Lean Coordinators

Executive & All Divisions

Lean Leadership

Rapid Improvement

Events Introduced

Focused on Foundation and Leadership Training

Lean Journey Cont. 2014 – 2016

Lean Awareness for all

Manufacturing team members

Are we Solving the

right problems?

BPC Value Stream

Mapping workshop

1st Lean Practitioner

projects completed

Sept

14

Nov

14

Dec

14

Mar

15

Jul

15

Aug

15

Oct

15

Jan

16

BPC Lean Coordinator appointed

BPC Line of sight

workshop

BPC Team Member Lean Practitioner

training

Suggestion Scheme takes

flight

Regional Awareness, Training and Projects

Embedding Lean in the Strategy

2014

(Internal) Manufacturing KPIs

SAFETY QUALITY SERVICE COSTOUTCOMES FOR

CUSTOMERSOUTCOMES FOR

PEOPLE

HAZARD:INCIDENTS

REPORTED RATIO

RIGHT FIRST TIME

DIFOTPRODUCTIVITY

andCOST PER PRODUCT

CUSTOMER SATISFACTION

EMPLOYEE ENGAGEMENT

We will continue to focus on

improving the safety of

our workplace

We will continueto focus onproducing

quality products

We will improveefficient &

reliabledelivery

of our product

We will responsibly manage our costs & maximise

conversion of donations

to component

We will deliver products& services that are

nationally consistent, reliable and meet the

needs of our customers

We will attract & retain

the best staff for the work we do

Restructure of Production Activities

Provides the catalyst for change,

coordinates Lean & RIE programs

Supports the business through

coordination of non-core and

administrative services

Provide scientific and technical

support, troubleshoots, manages

deviations

Scientific & Technical

Services TeamAdministration Lean Coordinator

Undertake core testing

Testing Team

Process blood components

Processing Team

Production

Scientific and diagnostic services

Red Cell

Reference Team

Quality control of production

Process Control

Team

Specialist Services

Manufacturing Support

Focused on targets,

efficiency and quality,

delivering the production

schedule in a nationally

consistent way

Focused investigation,

service, quality and

building expertise

in a nationally consistent

way

Focused on enabling production and continuous improvement in a nationally

consistent way

April 2014

Processing Productivity

- Post implementation, 9% increase for 2013-14

- As at Jan 2014-15 YTD, a 15% improvement

2000

4000

6000

8000

10000

12000

14000

SPC

MPC

BPC

PPC

National

We

igh

ted

Pro

ce

ss

ed

Co

mp

on

en

ts

pe

r F

TE

Testing Productivity

All four major processing centres have continued to achieve productivity improvements after

the introduction of the new structure in April 2014.

- Post implementation, 16% increase for 2013-14

- As at Jan 2014-15 YTD, a 45% improvement

4000

6000

8000

10000

12000

14000

16000

SPC

MPC

BPC

PPC

National

Co

re T

es

ts p

er

FT

E

Cultural Change and Lean, post restructure

• Daily production meetings and huddles focusing on manufacturing requirements

• Daily – Weekly Gemba walks, monthly across shift Toolbox communications

• Suggestion scheme launched with a focus on JDI’s (just do it) and Kaizen events – we want your ideas

• Introduction of visual management into all areas of Manufacturing (and also uptake into Donor Services and Medical Services)

• Production scheduling tool utilisation, brain storming sessions, adhoc problem solving and 5S

Work practice changes implemented which focus on

manufacturing and lean principles:

April 2014

BPC - Suggestions

Strategy Deployment - Acid Test – March 2015

In any division and any team member…..

Could you get the correct answer to the following questions?

1. What is the KPI’s/Strategic Plan for this business over the next few

years?

2. What are you doing that is different to contribute to our

KPI’s/Strategic Plan ?

Most Team Members answered question 2 of the

acid test = they are doing Nothing!!!!!

“Doing nothing, is a great way to change

nothing”Kid President

What’s our Foundation?

Name some of our Objectives from Strategic Plan?

What are Our targets?

ObjectivesKey Performance

Indicators

National Regional

15-16 Target14-15

Result15-16 Target

14-15

Result

SAFETYContinue to improve the

safety of our workplace

Hazard: Incidents reported

ratio> 50% N/A > 50% N/A

QUALITYContinue to produce quality

productsRight First Time ≥98.5% N/A ≥98.5% N/A

SERVICE

Improve efficient and

reliable delivery of our

products

Delivery In Full On Time

(DIFOT)≥97%

Red Cells 96.8%

Platelets 96.2%

Cryo 93.7%

≥97%

Red Cells 97.0%

Platelets 97.0%

Cryo 97.0%

COST

Responsibly manage our

costs and maximise

conversion of donations to

components

Productivity:

Testing

Processing

Customer Service

Order Fulfilment

18,200

13,000

931

532

14,987

12,151

N/A

N/A

22,040

15,776

N/A

N/A

18,100

15,101

N/A

N/A

Cost Per Product <$85 85 86 86

CUSTOMER

Deliver products & services

that are nationally

consistent, reliable and

meet the needs of our

customers

Customer Satisfaction 8.9 8.9 8.9 9

Driving Lean culture?

4 Lean Principles

We work in a standardised way

We do our work at the right time

driven by our customer

requirements.

We level out activities across the

time available.

We never pass on poor quality to

the next process.

5 Lean Behaviours

We go, look and study at the

place where the work happens.

We respect the individual and

utilise their potential.

We work as a team.

We constantly challenge the

current situation.

We strive to make small

improvements every day.

August 2015

Why Value Stream Map?

Problem

We had no clear line of sight between the numerous projects /

improvement activities being undertaken at the BPC and the

Corporate or Manufacturing strategic goals and targets.

This was resulting in potential wasted effort in resources, time and

an inability to meet crucial business deliverables.

Goal of the work shop

The goal of the workshops is to develop and agree on roadmap of

activities for the BPC that will contribute to the Red Cross Blood

Service strategic goals & objectives

August 2015

BPC’s Value Stream Mapping

Line of Sight

Value Stream

Mapping

Charter of Continuous

Improvement Projects

Where’s our Non-Value processes?

Processing Testing

Order Fulfilment

/Customer ServiceRed Cell Reference

Where’s our Non-Value processes Cont.?

Team Project HeadingTime

FrameTeam Project Heading

Time

Frame

Customer Service - work load and Resourcing shortOrder Fulfilment/

ProcessingTime ready for O neg red cells - Visual Management short

Order Making Process - IVIG and Research orders - Review process looking

for quick winsmedium Processing Platelet release time - Set up Standard Work short

Customer feedback - Customer ordering patterns i.e. cut off times - SLA medium Remove the use of dry ice for plasma boxing - Review standard work short

New AHP approvals - Review Process medium Processing Shipper unpacking area - safety improvement short

Customer Service - layout review medium Processing - Buffer / Shipper management short

Managing in coming calls into Customer Service - System/ Equipment long Release label CMV - visual board short

Loading dock Trolley signage - Visual Management short Review the value of blood-in forms medium

Dispatch window - answering door / buzzer for non blood service related

enquiries - QUTshort Reduce centrifuge cycle time medium

Order Fulfilment - Buffer / Shipper management medium Processing - layout review medium

Order Fulfilment - layout review mediumEnsure right details entered in NBMS to eliminate need for discard

checking / correcting errors @ receiptinglong

Portable interface/unit with NBMS - CSL plasma issue long Processing hyperimmune HEP-A plasma to transform @ SPC long

Manufactured Product Review - Ordering, Receipting, Inventory long Scheduled work - Set KPI for BCS - setting batch times short

CMS Improvements - Training for Transport Team Members short Testing - Buffer / Shipper management short

Transport - Buffer / Shipper management mediumChecking Plates for PK results - can use photo - reduced safety RSI -

Review manual handlingshort

Review Driver's run schedule - GPS, Go Booking, Blood in schedule. medium BCS why do we have the highest false positive rate medium

Processing, Testing Move BCS into a Processing task long Testing - layout review medium

Processing, Testing,

TransportBlood In Schedule - All medium

Consignment tracking for sample shippers, Shipper tracking from Centres -

CMSlong

Investigate actual numbers of HTAB - Platelets needed per day - Review short Better alternative packing type CSR - Dry Ice medium

Automated print anomalies - Review short

Transport

Charter of Continuous Improvement Projects For BPC 2015/16

Customer

Service/Order

Fulfilment

Processing

RCR

Testing

Learnings from recent developments

In some parts of the business there are still pockets of

resistance to change, this requires independent change

initiatives.

Value Stream Mapping event – was a game changer for morale

and other lean activities – TM Lean Practitioner Training

Still finding it difficult to get staff off the floor in some teams to

complete improvement events.

Great value from team owned Just Do It’s (JDI).

Local leadership team driving Lean improvements – Lean

Leaders

Quality – Right First Time

Target >97.0%Value

Stream

Mapping

Lean

Practitioner

Training

1332

1058

742 720 715

Components Not Required

Safety – Target 50:50 Hazard to Incident

Safety Gemba

walks introduced

Customer Satisfaction – Target >8.8

Manufacturing

Restructure

Lean Maturity Self Assessment

Any Questions?

Joe Patkes

BPC Production Manager

Jpatkes@redcrossblood.org.au

Josh Duncan

BPC Lean Coordinator

Jduncan@redcrossblood.org.au