Lean Design in the Medical Laboratory - the British Columbia ...

Lean Design in the
Medical Laboratory
British Columbia Society of Laboratory Science
October 1, 2010
Shana Padgett MT(ASCP)
Sr Lean Consultant
ValuMetrix ® Services

Teaser…
Lean Design is so much more than the answer
to the question of
“Where do we put the analyzers?”
© 2010 Ortho-Clinical Diagnostics, Inc.

Introductions
• What do you think when….You hear the word “Design”?
© 2010 Ortho-Clinical Diagnostics, Inc.

Introductions
• What do you think when…. You hear the words “Lean Design”?
© 2010 Ortho-Clinical Diagnostics, Inc.

Calibration
• Who am I?
• Why is this topic of great importance for
laboratorians?
• Why did you choose this program?
© 2010 Ortho-Clinical Diagnostics, Inc.

ValuMetrix ® Services
Leadership in Healthcare
• Since 1999, ValuMetrix ® Services has brought Johnson & Johnson
Process Excellence (PEx ® ) expertise to healthcare organizations
• Uses the proprietary ValuMetrix ® Production System toolset
• 100% Healthcare
• Diverse consultant experience
• Improvement, not reports or benchmarking
• Consultants on-site, managing project and managing change
• Delivering breakthrough results using the PEx ®
model enterprise-wide
– Hospital Enterprise Deployment - Emergency Department
– Executive Leadership Training - Diagnostic Imaging
– Laboratory - Nutrition Services
– Pharmacy - Nursing Unit
– Perioperative Services - PAT / Billing Services
© 2010 Ortho-Clinical Diagnostics, Inc.

Calibration
• Who am I?
• Why is this topic of great importance for
laboratorians?
• Why did you choose this program?
© 2010 Ortho-Clinical Diagnostics, Inc.

Calibration
• Who am I?
• Why is this topic of great importance for
laboratorians?
• Why did you choose this program?
© 2010 Ortho-Clinical Diagnostics, Inc.

Agenda
• Formalities
• Definitions
• Physical Plant
• Human Interface
• Measuring Performance
© 2010 Ortho-Clinical Diagnostics, Inc.

Design
1 : to create, fashion, execute, or
construct according to plan
2a : to conceive and plan out in the
mind
2b : to have as a purpose
2c : to devise for a specific function
or end
- Merriam-Webster Online Dictionary
© 2010 Ortho-Clinical Diagnostics, Inc.

Lean Design…
The integration of
The Factors of
Production
People
Materials
Machines
Into a carefully arranged
and well designed process
In order to:
Provide the right products
or services, at the right
time, at the highest
possible quality and at the
lowest possible cost.
Doing what the
customer needs,
when it is needed,
the right way, the
first time.
© 2010 Ortho-Clinical Diagnostics, Inc.

Lean is…
• The creation of continuous flow and the
elimination of waste (“muda”) in order to increase
the value-added portion of the process
• A Structured, Methodical, Systematic approach to
solve complex process problems
• A starting point for a journey of a continuous
improvement process
© 2010 Ortho-Clinical Diagnostics, Inc.

Lean Design –
The Physical Plant

How does the space look?
• Why did we put analyzers there?
– “They belong to that department.”
– “That was the only open spot”
– “The only 220V power source is there.”
– “That spot is closest to the key operator.”
– “…..”
© 2010 Ortho-Clinical Diagnostics, Inc.

Macro Design
• What do your customer’s need?
– INR in

Macro Design
• Product drives layout
– The What not the Who
• What are your constraints?
– Water, Drains
– Pillars
• What is your legacy?
– Departments
– Cross-training
© 2010 Ortho-Clinical Diagnostics, Inc.

Group Technology
• Examines the total mix of products and processes
• Segregates products into similar groups or
families that become the basis for cellular design
• Strives to identify groups of products that use
similar processes and sequences
• Leads to cellular design
© 2010 Ortho-Clinical Diagnostics, Inc.

Macro Design
68%
• Volumes
• Specimen
Sharing
• Adjacencies
• Centrifugation
• Staffing
• Walking
• 1 st – 2 nd – 3 rd
15%
17%
© 2010 Ortho-Clinical Diagnostics, Inc.

Macro Design
• Volumes
83%
• Specimen
Sharing
• Adjacencies
• Centrifugation
• Staffing
• Walking
• 1 st – 2 nd – 3 rd
3%
14%
© 2010 Ortho-Clinical Diagnostics, Inc.

Cell Design Example for Core Lab
Core work area for the clinical Lab Technicians
performing 90% of all lab tests
Label
Bio
Haz
Sam
ple
V950
Cap
s
Misys
Monitor
Label
Misys
Monitor
Label
Misys
Monitor
Misys
Monitor
One person walking 6 cycles in 30 minutes
and operating 6 work stations
Material Runner can deliver from outside of cell
© 2010 Ortho-Clinical Diagnostics, Inc.

After Lean
© 2010 Ortho-Clinical Diagnostics, Inc.

Micro Design
• Prime Real Estate
• Do you have enough space?
– What do you store where the value-added work is
performed?
– How much do you store in the work area?
– How often do you use it?
– Who uses it? For what purpose?
– How are the items replenished?
– “Every shelf creates steps”
© 2010 Ortho-Clinical Diagnostics, Inc.

Disorganization and Oversupply
• Multiple storage locations
– Why are tiger top tubes kept in 8 different storage
places within phlebotomy?
• Not including carts/trays
– Are people stashing inventory out of fear? Why?
© 2010 Ortho-Clinical Diagnostics, Inc.

What is your current state?
© 2010 Ortho-Clinical Diagnostics, Inc.

© 2010 Ortho-Clinical Diagnostics, Inc.

Is Your Work Space “Visual”?
• Can any reasonably intelligent
person come to your department
and identify what is going on?
• Are there clear and unambiguous
signals?
• Are exceptions easy to identify?
• Are the right measures in place,
visible to all, and trended over
time to measure improvement?
?
“How do I help?”
© 2010 Ortho-Clinical Diagnostics, Inc.

5S
Sort Set in Order Shine Standardize Sustain
A Lean manufacturing tool focused on creating and maintaining
an organized, clean and high performing work environment by
eliminating non-value-added activities such as searching
around for tools and moving around in clutter.
It is the foundation for continuous improvement, zero defects,
cost reduction and a safe work area.
© 2010 Ortho-Clinical Diagnostics, Inc.

Micro Design – Material Layout Plan
© 2010 Ortho-Clinical Diagnostics, Inc.

Micro Design – Material Layout Plan
© 2010 Ortho-Clinical Diagnostics, Inc.

Micro Design – Material Layout Plan
© 2010 Ortho-Clinical Diagnostics, Inc.

Micro Design – Material Layout Plan
© 2010 Ortho-Clinical Diagnostics, Inc.

Lean Laboratory Design
© 2010 Ortho-Clinical Diagnostics, Inc.

Lean Design –
The Human Interface

Lean Laboratory Design…
What if I don’t do things that way?
Before
After
© 2010 Ortho-Clinical Diagnostics, Inc.

What is the best way?
• The design is now intentional
• The best way to reap the
benefit of any design is to use
the system as it was designed
to be used
• How do you know the “new”
way is better?
© 2010 Ortho-Clinical Diagnostics, Inc.

Standardized Work – Optimum Interface
• The current, one best way to perform work that
meets the customers’ needs.
– The customer determines what is needed
• The lab determines the best way to deliver on
these service level agreements
– Design the space for optimum performance
– Define the work processes to deliver effective and
efficient results – Every patient, Every time!!
• Measure, Meet and Share, Make it Better
© 2010 Ortho-Clinical Diagnostics, Inc.

Measure – Data Based Decision Making
© 2010 Ortho-Clinical Diagnostics, Inc.

How Are We Doing Today?
First Second Third
© 2010 Ortho-Clinical Diagnostics, Inc.

Summary
• Formalities
• Definitions
• Physical Plant
• Human Interface
• Measuring Performance
© 2010 Ortho-Clinical Diagnostics, Inc.

Questions?