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Lean Design for Hospitals

Enabling clinicians to deliver better patient care by eliminating wasteful activities.

Benefits of Designing a Lean Hospital

Reduced space requirements

Improved on-time starts

Reduced inventory of medical supplies

Predictable patient flow

Predictable staff requirements

Shorter response time to emergencies

Improved quality of care

Fully incorporated Lean principles

Lean Hospital Design Roadmap

In order to successfully complete a Lean Hospital Design project, it’s important to have a proven series of steps to document the process. We call that our Lean Hospital Design Roadmap. It’s an excellent jumping off point. We’ll start with the steps that are proven to work then work with you to customize our process to meet your needs and solve any pain points that you are having.

Define target departments

Define Target Departments

A hospital is a complex web of Units, Departments, and Support Entities. Pain points in the design must be clearly documented, so the Value Streams that affect those departments can be mapped.

Assess Current Performance

What is good, what is great, and what needs improvement in the target areas as they stand today?

Assess current performance

Align with Hospital Goals

It is not uncommon to see Metric sets that do not align with the Hospital/System Goals or even its Strategic Pillars. New metrics may be defined and old ones discontinued. We are also looking to measure the success of the Future Space.

Define Critical Value Streams

Define Value Streams that are the most likely to affect the design of the Future Space. The selected Value Streams will cover everything from Patient Flow to Case cart Picking to Staging.

Defining goals
Value stream mapping

Current Critical State Value Stream Mapping

All critical value streams are mapped and all opportunities for improvement are documented and categorized. At this point in the process, you will also begin tracking improvements by creating a Continuous Improvement Database.

Log Improvements Database

Start building the Continuous Improvement Database by logging improvement ideas that impact the design of the Future Space. These processes will provide the Architects with the best information for their physical design.

Log improvements
Improvements

Log Phase II Improvements Database

The second batch of improvement ideas are not likely to impact the design of the Future Space, but must be worked on in the intervening time between the end of the design and the cutting of the ribbon for the Future Space, so that they’re ready to be implemented as soon as they are needed.

Design Future Critical Value Streams

With the current state documented and the improvement opportunities logged, we turn our attention to optimizing critical value streams and developing standard processes and procedures that will make their performance predictable and sustainable.

Designer

Document Future Procedures

Every last procedure is documented using Standard Work documentation. Whenever training is necessary, training materials are developed and deployed.

Identify Space Requirements

For every process, a space requirement is developed and/or calculated.

Puzzle
Review

Review Space Requirements with Architects

Every proposed space requirement is evaluated as a team with the Architects leading the review. A feedback loop for re-defining the spaces is put in place.

Fine Tune and Document

All spaces are documented and provided to the Architects to put together the physical design. This will be an iterative process with several reviews and corrections.

Fine tuning

Critical value streams

Every Hospital we know and have worked with has Patient Flow problems that are reflected in the Patient Satisfaction Scores and on Physician efficiency. Patient Flow is the Value Stream that we pay the most attention to. We not only Map the Value Stream, but also define Process Flow Diagrams for every Patient category.

Patients are, in many cases, moved from one area to another using some kind of conveyance device, from stretchers to Isolettes. Failing to account for patient conveyance in the design, results in loss of time “hunting” for the device as well as a general disorganization in the area (messy aisles and alcoves).

We see this time and again: Everybody is ready in the OR but the C-Arm is nowhere to be found. Why? Because equipment flow was not designed into the Future Space so the C-Arm or the Wilson table are store in a different place (more like thrown in a different place) after every procedure.

The Case Carts are in most cases assembled in large batches that force the Architects to designate large spaces to hold idle case carts that will wait for 12 or 18 hours before anybody places their hands upon them, generating waste all around.

Instrument sets must arrive to the OR when needed and no later. To do so, they must leave the OR on time and in the right condition and arrive to the Sterile Processing in a time no lonhger than the actual transportation time.

The storage, retrieval, use, re-processing, and re-storage must be designed into the Future Space to maximize Clinician’s efficiency and Patient Care.

Hospital Materials Management practices vary from poor to appalling. When Architects are forced to design around those processes, Clinicians end up with more of the same: constant hunting and wasting of time looking for medical supplies, just in a nicer-looking space.

The day I saw en Environmental Services employee dragging a trash bag out of an OR will forever be etched in my memory.

The day I saw en Environmental Services employee dragging a trash bag out of an OR will forever be etched in my memory.

Deliverables

Our goal is not to make you “consulting junkies”, quite the opposite. Our Lean Hospital strategy contains a clear exit strategy for your consulting help, once you’ve developed the internal capabilities and systems to continue upwards on your own.

Improvement Database

Typically, dozens of improvement opportunities are identified during the project. These ideas will be the foundation of your Kaizen program.

Current state value stream maps

An unbiased analysis of the way work is currently performed, on the most important work flows that impact your patients.

Future state value stream maps

The start-to-finish flow chart of the most important work flows, and the foundation for your Lean Hospital Design.

Future state procedures

Without standardization there can be no improvement. Create user-friendly procedures for all critical processes.

Get started today!

Gerard Leone

Contact Gerard Leone, Principal of our Lean Hospital Practice, to find out how we can assist your Lean Hospital Design efforts.

Email: gleone@leonardogroupamericas.com

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