Workforce Implications of LEAN Principles in action: Front End Laboratory Re-DesignChristine MorrellDr Wynne WilliamsAberTawe BroMorgannwg University NHS Trust

Improvement Project

Six Sigma Uses statistical tools to uncover root

causes and reduce variation

LEAN Seeks to improve flow and eliminate waste

Speculation

“There is a lot of speculation and I guess there is going to continue to be a lot of speculation until the speculation ends”

George W. Bush

Eliminate Waste- SWIMTOOT

Scrap (It just doesn’t meet expectations) Waiting (Things just don’t happen when they should) Inventory (Keeping stuff on-hand when it isn’t required) Motion (Excess movement -person/material -within a

process) Transport (Shipping stuff to different locations) Over Production (Doing more than you need to -output of

a process) Over Processing (Doing more than you need to -within a

process) Talent (Using skilled people to do unskilled jobs)

Sample Reception - Lab Redesign Phase 1

Consultation Process

Independently staffed and managed At Front of House

Design a laboratory

Ideas

“ We have nothing against ideas. We’re against people spreading them.”

Augusto Pinochet. (former military leader of Chile, accused of fraud and human right abuses)

HaematologyMLA

Clinical Biochemistry

MLA

Clerical Staff

Phlebotomist

Autoclave Operative

PathologySupportWorker

Pathology Support Worker

Options

Phlebotomist

Pathology Support Worker

Pathology Support Worker excluding Phlebotomy

Multifunctional Workers

Must be well trained

Insulation against absenteeism and vacations

Creating a Continuous Improvement Mindset

Band 3 & 4 staff

Band 3 Phlebotomy Training/MLA Senior Phlebotomist/MLA

Band 4 Office Manager

Specimen Reception Manager

Key Competences H.R. Management Training Quality

Skills Analysis

Training and Competences

Training Logs Competence Assessments Evidence of Continuous development

e.g. Attendance at CPD sessions Lean Team Presentation Involvement in preparation of Laboratory

Instructions

The Lean Workforce

Flexible Motivated Aligned to Demand Appropriate Competences

Access to Appropriate Training

Putting People First

Improve employee morale through • Using Lean to solve “every

day”problems • Improved lab performance and patient

care • Staff empowerment via Lean methods

Flexible working - A4C (37.5h)

Introduction of Flexible working Early starts and finishes Shortened Lunch Breaks Late starts and finishes

Visual Clues: Staffing Levels

Work Force Implications

Managing Expectations Structure on to which hang

Competences Appropriate Extended Roles

Healthcare Scientist Career Framework

“To those of you who have received honours, awards and distinctions, I say well done. And to the ‘C’ students, I say, you too can be President of the United States

George W. Bush (US President)

Challenges

Pathology: towards a competence based workforce

A report of the Pathology Profiling Project. May 2008

Improvement in TAT

Turnaround Times: GP & OPD U&E

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TAT: “U&Es - Cold

2005/06 4.25

2006/07 4.62

2007/08 3.03

2008/09 2.1

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Turnaround Times :Troponin T

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Thankless Tasks

“It’s not so much a thankless task. It’s more a job with no thanks.”

Colin Baker. Dr Who.

The Lean Workplace

Delivery of a Quality Service in the most cost effective manner