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Applying Lean to the wards Michael Ballé Anne
Régnier
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Lean is a system

• Many have heard about the lean  tools  5S,
  Value Stream mapping, Kaizen events, etc.
• Lean veterans insist on applying the tools
  rigorously
• But mostly on the fact that lean is a  system ,
  or a way of  thinking 
• What do they mean by that?

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Lean as a learning system
tools
system
thinking
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What is lean thinking?

• Visualize performance problems in the ward
• Solve problems without  going around  them
• In a  lean  way using ideas rather than
  investment
• By involving all employees
• And developing a kaizen mentality in everyone

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Lean thinking is guided by a lean system
CUSTOMER SATISFACTION
React at first defect
Flow at takt time
Employee Involvement
Standardization
Continuous Improvement
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Lean success needs working at all three levels
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To begin with walk the wards
Gemba walk
Customer satisfaction
Go and see
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Gemba walk
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Gemba walk
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Gemba walk
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Customer satisfaction metrics
metrics
customer satisfaction
performance mindset
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What is a customer incident?
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Standardize work areas
5S
Standardization
Involve the teams in visual management and quick
response to problems
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5S
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Clear the workspaces, identify locations
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Create supermarkets and hunt for out-of-date or
missing material
Supermarkets
Flow
Visualize out of date or missing material and
eliminate
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supermarkets
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All the way to housekeeping material
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Make sure material is desinfected after each use
Team problem-solving
Standard/kaizen
Visualize problem and solve it by involving the
team
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Clear and clean after every use
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Clear and clean after every use
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Reduce inventory on hand so problems can be seen
at one glance
Daily ward walk
React at first defect
Visual management And quick response
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Bacterial bombs!
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Visual management for quick response
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From the work environment to care itself
Work standards
Standardization
Involve team in creating their work standards
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Work standards for care
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And more complex problems preparing patients for
physiotherapy
Value Stream Mapping
Patient flow
Develop teamwork between Specialisms and
solve Patient problems
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And further challenges

• Moving to kanban for all supplies (which means
  convincing hospital logistics)
• Tracking the path of BMR through the wards
• Improving patient journey and getting involvement
  from the doctors

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What results?
Over two years, the rate of incidents per patient
halved (that is, the probability each patient
admitted has of facing an incident reduced by 45)
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Lean is a learning system

• The lean environment (visual management, pull
  system) helps people to see cause and effect
• The lean tools are learning opportunities, for
  people to learn to produce with better, quality,
  delivery, productivity and flexibility
• The tools only highlight problems, resolution
  with PDCA is the point!

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Lean is a management system

• Using the tools will not transform the culture
• The lean culture is about solving all problems
  rigorously
• To understand real priorities
• And create another type of relationship with
  workers
• Based on developing abilities
• And creating better products, through better
  thinking

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The team!
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Thank you

• To the team from Villeneuve, Nord 92
• To visitors from Bolton Hospitals
• To you, for your attention