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Value Stream Mapping

Value Stream Mapping. Aims for session. Introduce the concept of Value Stream Mapping Consider identification of value and waste. Diagnostic tests. Patient Flow Process. 1. Understand the total process of care delivery – patient pathway.

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Value Stream Mapping

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  1. Value Stream Mapping

  2. Aims for session • Introduce the concept of Value Stream Mapping • Consider identification of value and waste

  3. Diagnostic tests Patient Flow Process 1. Understand the total process of care delivery – patient pathway

  4. COMPASS WAITING LIST DIARY - CASE NOTES PULLED 3 WEEKS IN ADVANCE THEATRE LIST PRINTED L4 HOURS BEFORE - ALLOCATE BEDS THEATRE LIST SAME DAY FROM JANET. TRY 24 HOURS BEFORE REPORTS ADMISSION AT FRONT RECEPTION. DETAILS CHECKED PATIENT ARRIVES RECEPTION DAY SURGERY TAKE PATIENT TO WARD AND TO BED AREA WITH NOTES. ADVICE TO UNDRESS/GOWN ON. TELL NURSING STAFF. RECEPTIONIST FINDS OUT IF THEY TO GO TO RADIOLOGY AND WHAT TIME 1 WEEK IN ADVANCE ADMIT PATIENT VIA CARE PLAN. 5-10 MIN. LOOK AT MOD CHECK IF TO GO FOR ULTRASOUND - IF TO GO WALK THEM ROUND TO X-RAY WAITING ROOM. 1ST KUB - KID URETER BLADDER X-RAY. PATIENT FULL BLADDER. 2ND ULTRASOUND 20-30 MINS IN RADIOLOGY. PATIENT X-RAY AND ULTRASOUND REPORT BACK - BACK TO BED. DOCTOR SPEAKS TO PATIENTS - CONSENT SIGNED THEATRE STAFF ATTEND DAY SURGERY - DATA SHEET GIVEN TO DAY SURGERY STAFF. THEATRE STAFF TAKE PATIENT STRAIGHT INTO MINOR OP THEATRE. TEST 10-15 MIN ALLOCATION DR CANNING 3 1/2 HOUR SESSION VERBAL REPORT TO PATIENT AND INFORMATION. TAKEN BACK TO DAY SURGERY IF DOCTOR NEEDS TO SEE- APPOINTMENT MADE STRAIGHT AWAY - GIVEN TO PATIENT MAKE SURE PATIENT OK - ? DRINK OR EAT. DISCHARGE INSTRUCTIONS FOLLOW/REVIEW AT OUTPATIENTS VOL APPOINTMENT NEXT DAY. INDICATED ON CARE PATHWAY IF RAH DR WILL INDICATE ON TAPE - SECRETARY WILL ARRANGE.

  5. NURSE ESCORTS PATIENT TO CHANGING ROOM WITHIN THE EXAMINATION ROOM. PATIENT ATTENDS RADIOLOGY DEPARTMENT FOR ULTRASOUND AFTER SCAN PATIENT REPORTS TO RECEPTION DESK IN OUTPATIENTS DEPARTMENT PATIENT CHANGES INTO GOWN AND JOINS DOCTOR IN THE EXAM ROOM DOCTOR EXPLAINS EXAMINATION AND CONSENTS PATIENT. PROCEDURE CARRIED OUT. RESULT GIVEN IF APPROPRIATE AND FOLLOW UP INFORMATION GIVEN PATIENT CHANGES BACK INTO CLOTHES AND LEAVES THE DEPARTMENT. REPORT TYPED BY UROLOGY SECRETARY AT RAH

  6. What is Value? Hairdresser activity

  7. What is value? The activity is done right first time The activity transforms the patient and moves them towards the next defined outcome The activity is something that the patient cares about

  8. Define Value in Your Service Who are your patients? What is the ‘value’ your patient wants? How is the value added? When you describe value use the customers' words

  9. Stage 2: Waste

  10. Opportunities to Remove Waste: Waiting – delays for things to happen Mistakes – things going wrong Uncoordinated activity – things out of sequence Stock –too much or too little Transportation –moving info / things Motion – unnecessary human movement Inappropriate processing – unnecessary work

  11. Activity: Watch the video, identify and discuss the different sorts of waste shown

  12. Value Stream Mapping the patient journey Define start and end points • Supporting Organisational Structure: • Sponsor • Team Lead and Clinical Lead, Team Members

  13. Who to Involve • Small team 8-12 people, mixed disciplines • Represent people at all the steps you will look at • ‘Fresh eyes’ • Patients/ carers • Nominate a team and clinical lead

  14. What to Measure Agree beforehand improvements in - Journey time for patients - Time spent on non value adding work - Throughput (productivity) - Morale / staff satisfaction

  15. Observe and Gather Data • Walk the patient journey - see the actual work place • Follow and make notes about each component • What happens to the patient • What staff are doing • What the information / communication flow is • Take photos of wastes

  16. Measure the distance patients / staff have to travel

  17. Track both the patient and information flows

  18. Take the cameras on the walkabout, you’ll never convey this verbally!

  19. What do patients actually experience and say about the process?

  20. Ask staff at each step for their views on ‘show stoppers’, frustrations and positives

  21. Build up the Value Stream Map Walk the Area Collect real time data Have plenty of space Don’t rely on hearsay Take photos Don’t skip process steps Don’t assume Define the Boundaries of the VSA

  22. Understanding your Current State Map: Add value Remove waste

  23. Quantifying Value Added Activity and Time: Value Adding Non Value Adding

  24. Highlight opportunities to reduce waste on the map • Waiting • Mistakes • Uncoordinated activity • Stock • Transportation • Motion • Inappropriate processing

  25. Ideal State What process would the team design to align the value adding steps in the right sequence, complete the process as fast as possible, right first time, and reduce or eliminate waste? What would the patient, staff and information steps look like?

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