Archiwum dla miesiąca: November 2016
Hospitals tour – Germany
During Second Polish – German Health Summit on 17-18.11.2016 participants have possibility to visit some hospitals. Group visited 3 hospitals in Germany:
- Greifswald University Hospital
- Heart and Diabetes Centre, Karlsburg Hospital
- AMEOS Hospital Anklam
Hospital in Greifswald was presented by Mr Marek Zygmunt. This medical unit has 926 beds for patients and it is clinical, multispecialistic, iniversity hospital, which enrolls 130 thousands ambulatory patient per year and 36 thousands stationery patients per year. This is very advanced complex of buildings, which also uses lean healthcare tools. Some of the building are far away of each other, even 300 meters, so that used pneumating tubes solution, which can send blood samples and drugs over 10m/sec. During weekends tak place about 20 to 40 teleconsultation, in professional adapted room. This is clinical process optimization. In many places we can meet visual management elements, as:
- 5S
- Defined material holding areas organization
- use of color for signs and marking
- different colours for blood samples
- procedures and instructions presented in more “user-friendly” way
- well designed layout/ infrastructure
- great signed corridors, showing direction
- using the most innovative logistic solution, as automated vehicle guided, for transport food, rubbish, bedding and more
- andon systems
Hospital in Karlsburg is modern place, which specializes in cardiovascular disorders and diabetes. Hospital was presented by Hospital Director, Prof. Dr. med. Hans- Georg Wollert. Every year 2500 cardiac and vascular surgeries and more than 5000 cardiological interventions are performed. 900 cases open heart surgery. About 2000 diabetes patients. Hospital has got modern operating theatre and use innovative valves. The oldest patient was 97 years old! This medical unit manage effectively of clinical processes, connlusion that conduct operation is cheaper and better that chronic patient treatment is real.
Next hospital was AMEOS Hospital in Anklam. We met with pleasant and warm reception. Top managements as well as medical staff were really involved in hospital presentation. Hospital dispose of 101 patient beds, also has implemented some solution from lean healthcare area:
- light and signal andon solution- opening door at every hospital ward
- 5S- well organized documents and forms and disposable materials
- Visual management, washrooms
In cocnlusion very hospital was big inspiration and fresh look for management, organization and approach for the patient, taking into account polish- german cooperation. Using len healthcare we can eliminate wastes which occurs in processes. It allows to reduce delays, raise level of quality medical services and shorten payment period for performed service. Listed above examples of visual management in practice evidenced that tool is also needed for reduction of “information deficit” in workplace [ Galsworth Gwendolyn, Visual workplace, Visual thinking (Portland, OR: Visual-Lean Enterprise press, 2005) 13]. It is important of process management and understanding client expectations. Not just end client but internal. Physician should organize his work in order to deliver service to patient in smoothly way, taking into account internal recipients and coworkers which contributes to process realization.
Managers of medical units should think about issues with lean healthcare approach. Think about:
- What problems are urgent and needed fast solution?
- If our problem is real problem?
- How current processes can be develop into processes with lean healthcare philosophy?
Second Polish – German Health Summit 2016
During 17-18.11.2016 in german city Greifswald took place meeting representatives of science, business and practice world. Very interesting programme provided everybody value informations and practical advices. The Second Polish- German Health Summit was organized in close cooperation with the State Chancellery of Mecklenburg- Vorpomern. It was taken at the University of Greifswald.
Chairs: Prof. Dr. Iga Rudawska University of Szczecin, Prof. Dr. Steffen Fleßa, University of Greifswald
Associate chairs: Univ. Prof. Dr. Jaroslaw J. Fedorowski, MD, MBA, Polish Hospital Federation; Dipl. Ing. Oec. Wolfang Gagzow, Hospital Federation of the German Land Mecklenburg- Vorpommern
First day was dedicated for presentations that concerns science and business life. Subjects of speeches were broadly defined of health care, mainly discussed good practices polish- german cross border – cooperation. Particulary interesting was presentation Mr Konrada Meissner i Lutza Fisher about cross – border emergency care. Next impressive lecture was prof. dr hab. Igi Rudawska about perceived service quality in chronic care- the empirical study. Next valuable presentation was that presented by Marcin Kautsch about development of e-Health in Poland from perspective of key stakeholders. Noticed that in Poland are presented e-registration and Electronic Health Record. Other solutions for data sharing as: telediagnosis, teleeducation, portable patient-monitoring devices, screening, telemonitoring can be meet in lower level. Speech of Marek Zygmunt about Assisted Reproductive Technology (ART) and cross border- cooperation raised current top issue. Other presentations were also very interesting and inspiring, were talking about data and facts that results from scientific research.
Lean Hospitals also was present and showed innovative approach to clinical process management using lean healthcare tools. What is clinical risk? Clinical risk means every risk, which negative influences at treatment results and quality requirements. Risk connected with medical services should be identified, under control, possible to avoid. In order to smoothly risk management, as first it is important to know all processes in organization. Then should be defined borders- start and end of the process. If process is defined better, it is lower risk level. Norms as PN-EN 15224:2015 Health Care services, Quality Management System, ISO 9001:2015, ISO 31000:2009, 31010:2009 contains requirements and rules, how organization should work to better manages their risks. Where find methods to manage more efficient? Lean healthcare – lean hospitals is an answer for that. Among other, you can use below tools and methods:
- FMEA- failure modes and effects analysis
- spaghetti diagram
- value stream mapping
- process flowcharts
- methodology 5S
- visual management
- ANDON system – sound and signal
- POKA-YOKE and JIDOKA solution
- medboards
- 5WHY
- Ishikawa diagram
- Pareto diagram
- Kaizen philosophy
In conclusion, if process are well known, their goals and client, it is possible to define potential risks. In order to appropriate risk management, norms, law and internal procedure should be followed to, therefore lean healthcare – lean hospitals tools should be used. This will improve processes – clinical process optimization. Philosphy Kaizen- “small steps” is basic to change culture of organization, company – hospital.
Nothing is particulary hard if you divide it into small jobs Henry Ford
Lean Hospitals at University of Technology
Lean Hospitals expands interests about lean management among young students. We participate in lectures at Koszalin University of Technology about lean management, process optimization. Our first meeting catched on fire with enthusiasm. Students of management, economy, finance and accounting departments have known basics of lean system and advantages it gives. Despite the fact lecture has been planned in details, subject wasn’t presented in 100%, because of lack enough time. We were talking about services process optimization, 5S methodology, Pareto, 8D, A3 problem solving.
During meeting were presented main foundations lean management philosophy, its aspects as: CTQ- critical to quality, VOC- voice of customer. Next phase was 7 wastes- muda with practical examples and movies . Also there was presented VM- visual management and 5S. All students during lectures had possibility to understand good approach to customer and his expectations (CtQ). What effects gives incorrect, incomplete and imprecise message. Results of this workshop are presented below, on the photo. During meeting also quality aspects were presented. In my opinion without knowing processes in organization, it borders, aim, it is hard to define value stream and internal client. If we know customer expectations, it is easier to desing process. Having designed process, we can find muda, for example: movement or waiting.
Next aspect is changeover, in production sector it is required SMED technique- changeover in less than 10 minutes. We should be aware that in services sector changeovers are also time-consuming, it descrease process efficiency about 30%. Len management can be used in different sectors as: healthcare (shorten patient waiting time for medical service, descrease inventory level in warehouse), accounting (lean accounting), IT, banking (decrease quantity of paper documents, the same actions, improve information flow, shorten time of claim processing).
Pay attention to those employees who respectfully ask why. They are demonstrating an interest in their jobs and exhibiting a curiosity that could eventually translate into leadership ability. Harvey Mackay
