Inventing the Lean Hospital Laboratory with Employee Engagement
Case Study Preview: Applying Lean methods to healthcare delivery processes is not easy in the face of resource constraints, variable demand and entrenched practices and beliefs. Read how one progressive healthcare system converted "Lean talk to Lean results" using a highly-effective, rapid team engagement strategy to transform output, yield and workplace stress in its central lab as well as many other patient service processes.
HealthPartners, one of the largest integrated healthcare providers in the Upper Midwest, has been a pioneer in applying Lean tools and methods to maintain the highest standards of care for its patients, while relentlessly looking for new ways to eliminate waste and reduce operating costs.
When confronted with the urgent need to meet patient expectations for same-day test results from its Central Lab, HealthPartners faced a ripe opportunity for "outside-the-box" Lean thinking and process innovation. The challenge: How to economically process over 3500 patient samples received each day from 25 different sites to provide data for accurate and responsive treatment plans?
A Lean Method Tailored to Healthcare
HealthPartners has faced such challenges before, having completed more than 50 large-scale process redesign projects over the past eight years, each supported by Breakthrough, an innovative Lean methodology from Leap Technologies uniquely suited for high-pace, time-constrained healthcare organizations.
"HealthPartners embraced the Breakthrough approach right from the start of their Lean journey as a more staff friendly, reliable and equally rapid alternative to traditional Kaizen Events popular in manufacturing settings."
According to Leap Master Coach Jim Peters, "From the very beginning of their Lean journey, HealthPartners embraced the Breakthrough approach as a more staff friendly, reliable and equally rapid alternative to traditional Kaizen Events popular in manufacturing settings."
With Peter's assistance, HealthPartners launched a Breakthrough team of lab technicians, administrators and material handlers to take on the challenge of reducing turnaround time on laboratory test results while still keeping costs in line with competition and reimbursement constraints.
Building Upfront Consensus for Lean Process Redesign
The Breakthrough approach to Lean process redesign operates on a simple premise: Fundamental improvement in complex, cross-functional processes requires effective and early agreement on a consensus vision for change with process stakeholders.
For HealthPartners' Central Lab Breakthrough team, creating a consensus vision for change in lab processes happened "right out of the gate" by applying Breakthrough's innovative and highly-engaging workshop for rapid process redesign. The self-named "Mission Possible Team" used the workshop to review the current state of performance and identify the business case for change, understand the current process, and drill down to the critical constraints and causes of chronic backlogs.
As important, the workshop provided the perfect setting for the team to learn about Lean concepts and methods and engage in a series of "What If" brainstorming activities to identify opportunities for eliminating waste and speeding the processing of lab tests.
Lean Solutions for the Lab Environment
The Mission Possible Breakthrough Team used the workshop as an innovation laboratory to develop three Lean-inspired solutions designed to facilitate delivery of same-day lab test results, including:
- Level Loading the delivery of samples to the Central Lab by moving up from three deliveries per day to six per day, resulting in a continuous, more even flow of work as well as better utilization of lab resources.
- Applying 5S, Standardized Work, Visual Management to create efficiencies within the lab at the "bench level," ensuring lab technicians operate with minimal disruptions.
- Installing an enhanced Kan-Ban System for replenishing supplies and reagent management, resulting in fewer interruptions due to misplaced supplies or tools and a faster match of specimens to the right instruments.
With our old ways of processing, the lab was overwhelmed during shipment arrivals. And at other times, instruments would sit idle waiting for specimens. There were lots of stops and starts rather than a continuous flow. With the Breakthrough redesign, we are able to utilize our inventory, staff and time much more efficiently.
According to Jackie Williams, Central Lab Manager and the Mission Possible Team Leader, "With our old ways of processing, the lab was overwhelmed during shipment arrivals, and at other times, instruments would sit idle waiting for specimens. There were lots of stops and starts rather than a continuous flow. With the Breakthrough redesign, we are able to utilize our inventory, staff and time much more efficiently."
Big Benefits for Patients and Lab Technicians
Implementing the Breakthrough team's actions produced immediate results which were nothing short of dramatic. For example, before the project only 42% of specimens delivered by 1PM were being tested and resulted by 4PM. Within a few weeks of deploying the "Lean Lab" solutions, performance improved to 93%!
Creating the Lean Hospital Lab with Breakthrough
42-93%improvement in same-day turnaround on tests
72specific improvements implemented
90 daysfrom team launch to completion
The Lean solutions allowed the Central Lab to deliver test results to care providers earlier in the day. As a result, critical patient care decisions could be made sooner. Of additional benefit: Improvement in the work environment from stress-reduction and higher morale among staff thanks to improvements in balanced workloads and better-organized supplies.
These levels of improvement in short timeframes are not uncommon when common sense (but often not common practice) principles are applied to tackling complex process improvement challenges.
When you bring all the stakeholders to the table and use a simple, but well structured process like Leap's Breakthrough method, impossible results become much more possible.
For HealthPartners, the results delivered by the Mission Possible Team and the Breakthrough approach to rapid process innovation were gratifying, but not surprising. As Mary Russell, HealthPartners Director of Lean Improvement, notes, "When you bring all the stakeholders to the table and use a simple, but well structured process like Leap's Breakthrough method, impossible results become much more possible."
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