Value stream mapping + kaizen workshops

The transforming organization reorganizes all work of healthcare into what are known as value streams. Value streams are patient-centered flows of care that support the patient through every step of the process, from primary care to the operating room to recovery and home. 

RCG’s value stream creation program allows organizations to take lean healthcare for a “test spin” before committing to a large-scale transformation program. Once committed, the value stream creation process is repeated whenever an organization turns its attention to a new medical condition or set of healthcare processes. 

Value stream mapping and kaizen (or continuous improvement) workshops are the draft horses of transformation. Both workshops are described briefly below:

Value stream mapping
Value stream creating begins by viewing the process from the patient’s perspective. In a five-day workshop, a cross-functional team of clinicians and support staff follows the patient through the care process, carefully recording the amount of time spent at each step at the process—and all the time waiting in between steps. The result is a value stream map, which is used to identify opportunities for improving patient safety and clinical outcomes by eliminating the seven “deadly” wastes: overproduction, waiting, inventory, overprocessing, transport, motion, and defects. At the end of the event the team creates a project charter (called an A3) that specifies a problem condition, sets improvement targets, and lays out a plan of action consisting of three five-day kaizen workshops. Over the next three or four months the client executes the improvement plan set out in the project charter. 

Kaizen Workshops
Based upon the analysis of the value stream map, candidates participate in three or more kaizen workshops to remove the most important wastes from the value stream. Each kaizen workshop is a five-day event that begins with a short introduction to lean healthcare for participants who are new the process. Then the team reviews the value stream map and does a “value stream walk” to identify opportunities for improvement in the areas and processes that have been scheduled for improvement. The balance of the week is spent “in gemba,” that is, on the shop floor, where improvements are trialed and successes are documented as standard work. On Friday the team presents its results to management. The results of improvement are monitored at thirty, sixty, and ninety days to verify adherence to and effectiveness of the new standards.

The value stream creation process may be repeated for additional value streams. Alternatively the process may be extended for the same value stream to realize a “model line”.