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Several years ago we realized that our management approach was not able to evolve fast enough to keep up with the changing environment
So we searched for a new philosophy and systems that could evolve ahead of the increasingly harsh environment. We looked around in health care and saw
Then we looked outside our industry, and found a model that we were sure could work in health care— the lean thinking philosophy, which we now call the Virginia Mason Production System (VMPS). J VMPS is modeled on the Toyota Production System, a management method with a halfcentury track record of success.
We’re in good company Toyota Honda Boeing Porsche WireMold Genie Industries
Japan Study Mission
Participants: •Visit the Toyota Museum •Participate in a Gemba Kaizen event at Hitachi air conditioners •Visit the Toyota assembly line •Commit to applying their learnings to a process they own within 12 months
Objection Virginia Mason is dealing with human lives, not industrial products. How can methods for improving manufacturing work be applied to a service like health care? J No argument that we are delivering something very different from a car. We are helping people who are sick, worried, vulnerable and afraid. These interactions can’t be mechanized. In fact, we want to be able to increase the valueadded time spent with our patients. J VMPS can help us do that by examining and improving the tremendous number of “processes” that surround and are embedded in patient care and support functions. For example, turning over an OR room is like a pit stop for a race car – and we know this has been improved over and over again.
What is VMPS? It is the method by which we manage and deliver on our mission and vision
VMPS Strategies Rapid Process Improvement Workshops Kaizen Events 5S Workplace Organization 3P (Production Preparation Process) Patient Safety Alert System (stop the line) Standards Alert System Everyday Lean Idea System Staff and Leadership Education & Training Evolution of Infrastructure
Improving the Infrastructure helps Focused goals aligned with organizational goals Explicit measurable targets Accountability for implementation and sustained results Enhanced leadership structure Enhanced “gemba” support Improvement never ends and is full-time work
Rapid Process Improvement Workshops (RPIW) The Virginia Mason Production System uses Rapid Process Improvement Workshops (RPIW) as its main tool to eliminate waste, improve processes, and increase productivity. There are “standard” measurements taken before and after each RPIW that quantify process improvements
RPIW Basics Go to the gemba and watch the process Collect data, down to the second, include the waiting time Separate value-added activities from the waste – get rid of the waste Simulate the improved process Create standard work Measure and track the improvement
The wastes Waiting Movement Transportation Defects Inventory Over processing Over production
RPIW Example Areas GI Endoscopy flow Operating Room turnover Radiology flow Specimen collection mistake proofing Pharmacy mistake proofing Emergency Department RN Rounds Capital budgeting Product review Instrument turnover Preference cards Case carts Omnicell standard set-up Implant standard process Non-stock inventory Receiving Information flow
Basics of the Lean Supply Chain Product standardization JIT deliveries – low unit of measure Delivery to point of care No warehouse High inventory turns External set-up (kits) Level demand
More lean supply concepts Highly automated– EDI Mistake-proofed Products pulled through the chain Standardized processes and data protocols Fewer vendors “New” relationship with vendors
What do we need from Manufacturers & GPO’s? Universal product code systems Reward innovation Put more products through distribution Transparency through the entire supply chain