Incorporating Lean Thinking into Facilities Design

© NETS Copyright Materials

Iain Smith & Gary Prior

North East Transformation System With Richard Johnston Gateshead Health

NHS Foundation Trust

Incorporating Lean Thinking

into Facilities Design


What is NETS?

NETS is:

• A model for change

• A method for improvement

The NETS Coalition is:

• An improvement collaborative comprised of

north east NHS organisations


Origins of Lean Healthcare

Lean

Manufacturers

Lean

Healthcare

Pioneers

NETS


The NETS Model

Vision

Compact Method

Patients

• What we want to achieve / clear aims

• Tools and concepts to help us

make improvements and achieve

our aim

• Clear expectations

• Behaviours

• People aspect of change

• Sustainability / making it stick


About the Health Foundation

The Health Foundation

• is an independent charity working to continuously

improve the quality of healthcare in the UK

• Health Foundation’s approach

www.health.org.uk

Identify Innovate Demonstrate Encourage

http://www.health.org.uk/


About the Health Foundation

The Shared Purpose Programme

• aims build knowledge and skills and create new

approaches to help transform healthcare quality

• is supporting nine award-holders to develop ways for

corporate support services and clinical teams to work

together to improve quality of care

• The North East Transformation System’s Lean Design

of Space Project is one of the nine to be funded.


The Design of Space Project

Aims to

• to design, test and document a structured

improvement event to incorporate Lean principles into

new or refurbished spaces and premises

By using

• a combination of kaizen (incremental change) and

kaikaku (step change) approaches

• team workshops to design the new space to

incorporate Lean principles


Our approach

Team based, disciplined, time-out workshops

in which people who do the work are

empowered to improve the work

Emphasises high participation of staff and service users


Our approach

Flows of medicine

• Patients

• Families and carers

• Staff

• Medication

• Equipment

• Supplies

• Information

Proto-typing & testing

Seeks to improve flow through rapid testing and proto-typing

Aims

Metrics

Changes


Design workshop case example


Standard Work SheetPrepared By:

Date Completed:

Department:

Process:

Process Boundaries:

From: To:

TAKT Time: Cycle Time:

17'32'' 12'15''

Scale: (Units per square)

Quality

Check

Standard

WIP

Safety

Precaution

GP, IMS

11 April 2013

Endoscopy, QE Gateshead

OGD (TS)

Patient Entry Patient Exit

Not to scale

7 Flows Key:

Patient

Staff

Medicine

Supplies

Information

Equipment

Family

Staff Nurse

(4.76 miles/day!)


3P Pro ject

W ho & W hat:

C ross functional

team of people

H igh & low leve l

p.o.v.

Focus on F low ,

Q uality & Safety

W here & W hen:

Q E G ateshead

W hy & H ow :

C hange

5 D ays

Endoscopy D ept

D ecide on w hich

option (O BC )

5 m onth , la te M ay

early June (Ju ly?!)

Early in design

stage

W orked on

Im provem ent

before

H igh utilisation

ra te (team )

Focus on Patient

F low

Know ing w hat you

know now w hat ...

D em and

R egulations

JAG

Intensive

w orkshop

Am bitious G oal

A lternatives ,

D evelop Top 3, 2D

F loorp lan, 3D

L ifesize

What did we do?


After


Results

• 70% reduction in patient

travel distance

• 2 hours per week

nursing time saved

through better

equipment flow

• 20% reduction in

procedure room size –

allowing more rooms to

be accommodated into

design


Next steps


Estates view

• Full team

involvement


Estates view Standard Work Sheet

Prepared By:

Date Completed:

Department:

Process:

Process Boundaries:

From: To:

TAKT Time: Cycle Time:

Quality

Check

Standard

WIP

Safety

Precaution

3P Team

11 April 2013

Endoscopy, QE Gateshead

OGD (Sedation)

Patient Entry Patient Exit

Scale: (Units per square)

Not to scale

7 Flows Key:

Patient

Staff

Medicine

Supplies

Information

Equipment

Family

Appreciation of the

processes in the

department.


Estates view

Appreciation of the

processes in the

designing of the

project.


Estates view

3D modelling quick to

visualise and change.

Rapid idea turn

around and testing.


Estates view

• Time will tell if changes are minimised

during construction.


Thanks for Listening!!

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