Post on 13-Apr-2017
transcript
Consolidating BJC’s Diagnostic Labs Eliminating Inefficiency
through Lean-Led Design
Today’s Speakers
Rodney Mullins Performance Improvement Manager BJC Healthcare
Brittany Hagedorn U.S. Healthcare Lead SIMUL8
Special Thanks to Mike Lee for his help in making this project a success.
Agenda
1. The Problem with Labs
2. Layout Optimization
3. Operational Planning
4. Question and Answer
BJH Overview
• Academic hospital
• Campus includes BJH and SLCH
• Trauma Level 1 Emergency Room
• Staffed Inpatient Beds: 1,167
• Annual Admissions: 54,738
Labs: Critical to Care
Diagnostic tests are used in 70% of all medical
decision making.*
70%
*Forsman RW. Why is the laboratory an afterthought for managed care organizations? Clin Chem. 1996;42:813–816.
Current State of BJH’s Labs
6+ separate labs, each with various
capabilities, scattered across the campus.
This resulted in inefficiencies and waste:
• Complicated logistics
• Delays in processing
• Excess staffing at slow periods during the day
Benefits of Consolidation
• Centralized receiving to simplify logistics
• Elimination of excess handling (if split
specimens between multiple lab locations)
• Reduce turnaround time for results
• Improve service to patients
• Increased capacity to support additional testing
Lean Design Approach
1. Value Stream Mapping (VSM) for
each existing lab to determine
workload and identify inefficiencies.
2. 5-day Rapid Improvement Event
(RIE) to develop an initial layout.
3. Simulation to estimate staffing.
4. Challenged to further reduce the
number of touches.
5. 2-day “mini” RIE to identify additional
improvements.
6. Simulation to compare both layouts
and anticipate impact.
Plan (Design Requirements)
Design (Rapid Improvement
Event)
Check (Simulation)
Act (Implement &
Review)
Design Questions
• What is the best layout for work stations?
• How will the new lab design handle the ebb and flow of
volumes over the course of the day?
• To what extent will staff roles and responsibilities in the
lab need to change?
• Will there be enough space for the full complement of
lab staff that will need to work there?
• How many staff will need to be on each shift throughout
the day?
Proposed Changes
• Consolidated work spaces and proximity to each
other in order to reduce the number of hand-offs and
the time spent walking between stations.
• Relocated the runner home base to provide better
visibility and reduce distance traveled.
• Created multi-functional overflow work stations to
handle peak volumes.
• Created single-piece flow that is based on a pull
model, to guarantee a FIFO inventory system.
Potential Layouts
1
2
A Superior Design
Queuing Time at Sort Queueing Time at Clerical Queueing Time at Manual
Min
ute
s
Initial Layout Improved Layout
With an improved layout, the team was able to further reduce the amount of time that samples would spend waiting in various steps of the process.
Staffing Plan
Next was to create a data-driven estimate for how many staff will be
needed to launch on day 1.
Staffing Decisions
At each level of hourly demand (250 arrivals in the above), the simulation was used to compare delays and overall lab performance for a range of staffing levels.
Sort Register
Min
ute
s (A
vera
ge W
aiti
ng)
3 staff 4 staff 5 staff 6 staff 7 staff
Anticipated Lead Time
250 arrivals per hour 420 arrivals per hour 580 arrivals per hour
Min
ute
s
Average Queuing Time
As a new facility opens, it is important to set expectations about what level of delay is realistic to anticipate, varying throughout the day due to demand. The above
values are for the total lead time to automation, assuming 5 water-spiders.
LeanHDX Live
Benefits of Simulation with LeanHDX
Data-driven decision making.
Quick to build and test scenarios.
Highly visual for stakeholder
engagement.
Complements existing Lean tools.
Questions?
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