Setting Expectations To Succeed With Lean Design
Clinicians spend the majority of their time on tasks that do not add value, such as walking extra distances to find supplies or having to make phone calls to check in on medication deliveries, Gerard Leone, principal, Leonardo Group Americas, told an audience at the 2014 Healthcare Design Conference in San Diego.
"We need to design spaces around processes that will reduce that non-value add time," he said.
During the session, "The Interventional Platform of the Future: Design Using Lean Principles and Tools," Leone and panelists Nancy Zupa, director of surgical services, White Plains Hospital, and John Rodenbeck, associate principal, Perkins Eastman, talked about how Lean design can help design teams and owners to design more efficient systems.
"Lean and flow processes are not about what we change today, it's about what we adopt and change forever," Leone said
At White Plains Hospital (White Plains, N.Y.), Zupa said the hospital set forth on a modernization project that included adding a six-story patient tower and four operating room (OR) suites, which are expected to be completed in 2016.
The facility started its Lean journey in 2012, looking at such areas as central supply, staff, and patient flow, and how they could improve efficiencies.
For example, looking at the central supply process, Rodenbeck says the project team found that dirty and clean supplies had to be transferred across public corridors and that a major supply room was so far way from work areas that the staff called the area "Connecticut."
The steps toward improvement included engaging all stakeholders to define the objectives and goals, defining critical value streams, and creating a road map to a Lean hospital design.
Looking at the issues surrounding its central supply, the team mapped out directional flow of supplies, including circulation patterns and where waste gathered in the department. From that process they were able to make informed design decisions to relocate the supply room to a more accessible location in the department that also kept traffic flow away from patients and visitors.
To improve the patient experience, the team decided to relocate the waiting room closer to the elevators, which would help to decrease patient delays and help staff implement more efficient work processes.
Leone says its important on a Lean project to set the expectations. "I'm designing a space around a process. It won't fix a broken process," he said.
He suggested starting with the processes, fixing what's broken, and then designing around those functioning flows. "Use a roadmap and follow it," he said.
The panelists said the efforts can result in a Lean hospital with improved outcomes, increased patient satisfaction, reduced waste, measurable performance, and a more engaged staff.
"When staff is part of the mix, you will see change," Leone said.