As hospitals and clinics struggle to balance rising costs with revenue threatened by reform and changing payer mix, capital investments, such as building renovation and expansion, must bring tangible savings.
As never before, preparation prior to construction should include a deliberate assessment of operational efficiencies, throughput, and flexibility to be gained. Construction, either new or renovated, offers a rare opportunity to resolve chronic process “work-arounds” and poor space utilization. An examination of work-flow using Lean Principles, ahead of and during design, can be applied to effectively guide the development of improved processes, and in turn, a more durable facility. The facility design should support best practices, not vice versa, and avoid an awkward post-construction conversation with clinicians and staff, “why didn’t you consider…?”
As you look forward to an opportunity to make a transformational change with the project (large or small), consider the following:
- Does your design team understand the opportunities in improved process flow? Have they examined how much “waste” in current processes hinders your staff from optimal performance?
- Has a clear vision of expectations for the facility been developed? Beyond replacement, are the objectives for the new facility stated in very tangible ways, and how process flow will be improved?
- Have you planned for “designated parking spaces” for movable equipment and Kanban for supplies to promote seamless transitions? These tools help prevent staff from searching for needed items and delays in care.
- Is the concept of standard work or “the best and accepted practice” embraced, and considered in the design of the new facility? (This is a hurdle for some organizations, but pays remarkable benefits when achieved.)
- Does the facility plan anticipate use of visual management tools and standard placement of supplies to promote, support and sustain process flow?
- Is there deep and sustained involvement by the front line staff and clinicians who deliver the care and understand current defects?
- Beyond the design process, is there a plan to operationalize the concepts imbedded into the design so the planned efficiencies are achieved?
- Have you incorporated mock-ups and simulations to validate planning assumptions to deliver a more detailed and practical design?
- Has the design anticipated evolving medical practice, technology and equipment change?
Borrowing from the success of other industries, health care organizations are leveraging these concepts to get the full yield of new construction, including:
- Efficient and flexible use of space, and potentially less build out
- Reduced change orders due to more rigorous and effective planning
- Clarified processes, with reduced variation and greater support by the users
- Improved satisfaction of staff and clinicians
- Better service to your customers
By integrating these design techniques into your planning efforts and deliberately focusing on workflow, the full benefit of a new facility can be achieved. Assess the skills on your design team and determine if they should be augmented. Do not ignore this unique opportunity. Transformational improvement can be achieved with focus on workflow in the planning process, and without significant investment. Other health care organizations have done it. You can, too.
Dan Schowengerdt of Schowengerdt Consulting, located in Minneapolis authored this article on Integrating Lean Planning into your Project. He is LEAN certified, a former health care operations executive and now LEAN Consultant. More information about his practice is available at www.sc-flow.com.