The Portsmouth Lean Journey - Medical Emergeny Value Stream
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by Maria Purse of Portsmouth NHS Trust shown at the Lean Healthcare Forum on 15th October 2008 ran by the Lean Enterprise Academy
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The Portsmouth Lean Journey - Medical Emergeny Value Stream
- 1. Medical Emergency Value Stream Medical Patient Pathway Admission to discharge ED See & Treat ED STAR Diagnostic & Assessment Cell in MAU Support services Discharge Planning
- 2. Medical Emergency Value Stream Current state
- 3. Medical Emergency Value Stream Future State GP FIFO Primary Diagnostics MPS OXOX Community Hospital X Ray Path’ Pharm’ OBS Decision Maker Home Referral Master Patient Scheduling 46 – 115 mins Home Secondary Diagnostics Spec Diagnostics & Treatment 95 – 282 mins 1525 – 7425 mins Proposed Future State VSM X Ray Path’ Pharm’ OBS Decision Maker
- 4. Surgical Emergency Value Stream Lessons learnt Clinical engagement & alignment Senior Decision Maker Establish Diagnostic Cell Emergency Theatre Single Patient Scheduler
- 5. Surgical Emergency Value Stream Current State
- 6. Surgical Emergency Value Stream Future State GP FIFO Primary Diagnostics MPS OXOX Community HospitalHome Referral Master Patient Scheduling Home Specialist Treatment Extend RTtC to Surgical Wards & Theatres X Ray Path’ Pharm’ OBS Decision Maker ’ Extend RTtC to SAU Understand and calculate Takt time Anaesthetic s Surgery Continuous flow operating to Takt Surgical Ward Buffer Continuous flow operating to Takt Establish pull system Establish single point of schedule Level discharge Establish Senior Decision Maker Establish Senior Decision Maker
- 7. Complex Discharge and Specialist Ward Value Stream New & Old Internal Colleagues External Partners Decision makers -v- shop floor Number of attendees The story of Mary TTO’s Social Care Occupational & Physiotherapy
- 8. VSM & Ops Management Ops Management the NHS Way Standing Operational Procedures VSM – managing perception & expectations Lean Facilitators Releasing Time to Care
- 9. Releasing Time to Care Organisation context & Leadership PatientCare Team Ward Organisation Support & Diagnostics Institute for innovation and improvement 2008
- 10. The VERY Steep Learning Curve Oh so very blind! Shared learning but differing style Listen to Mother or your Welsh Brother! Too optimistic Since when does no mean yes? Too little too late Prioritisation – Winter Planning Attendance = Work stream Knowing & planning the journey – flexibility needed