Success Stories — Healthcare
On Healthcare front, our consultants have worked with several US/ Canada hospitals including Children’s Hospitals, teaching hospitals, and general hospitals, including many Surgical Support Departments. Here are some example samplings of success stories from healthcare engagements:
A 650 bed hospital in suburban Cincinnati was in need of a new work process flow design for their Central Sterile Processing area. This area rated above the 80 th percentile in staffing according to Thompson Reuters Action O.I (target 50%) benchmark. There were service concerns around instrument/tray availability as well as supply reliability. The hospital established an internal LEAN initiative to address many of the supply related issues and needed a concentrated effort on the instrument processing aspect of the business. Primary goals of this engagement were process assessment and process reengineering specific to instrument processing, tray assembly, equipment distribution and case cart management/ picking.
- Recommend layout for Central Sterile (CS) decontamination and sterilization work flow. Develop and oversee a work plan to implement and maintain.
- Recommend layout for CS instrument tray build work flow. Develop and oversee a work plan to implement and maintain new “design”.
- Recommend case cart picking, management and delivery work flow (for instrument and reprocessables). Developed and oversee a work plan to implement and maintain.
- Identify and track initial, benchmark and on-going metrics to include CS staff-hours/case, Labor expense per case.
- Identify process and productivity deficiencies within the Central Sterile Equipment area.
- Benchmark processes, space allocations, productivity, instrument tray volume and quantity, instrument replacement and repair expenses against market and regional standards, as may be available. Determine realistic levels for CHC.
- Assess instrument inventory against instrument demand and indicate where excess or shortages exist.
- Develop Policy and Procedure documents for optimal work flow layout for supplies and instrument storage and instrument process flows.
- Determine optimal work assignment/allocations, staff schedules and staffing levels as it relates to work demand (current and short term future). Measure the effect against Thompson Reuters labor benchmarks (as may be appropriate or feasible) as well as other benchmark services that may be available to the consultant.
- Review and recommend job descriptions and organization charts to promote accountability on quality and productivity.
- Establish metrics to measure product quality to include a base and goal.
- Coach managers and supervisors to train staff on new processes.
- Recommend appropriate staff levels on shifts to complete the various functions within the new design.
- Review new building layout design to assure designed process matches (from instrument processing perspective)
- Recommend shelf configuration for all instrument storage areas and assure that stock levels will fit in allocated space.
- Develop a dashboard of metrics for various levels to view daily, weekly, monthly.
- Assess and benchmark the quality of service provided by Sterile Processing
- Operational savings $950,000 (includes inventory and labor)per annum
- Cycle time for instrument tray assembly improved by 23% over baseline
- Instrument pick errors reduced to .01%
- Detailed training program to support the proposed strategy
- Improved organizational structure to promote accountability
- Development of Key Performance Indicators to measure performance
A 1,050 bed hospital was in the process of constructing a new patient tower and Women’s Hospital that would provide replacement beds, additional NICU beds, new women’s SPD and OR suites. Construction project had multiple phases and total budget of over $1 Billion. The engagement involved the review the logistical processes in place and the development of recommendations regarding automated delivery systems.
- Assessment of basement space at the new patient tower; this will include high-level space requirements relating to following functions
- Materials Management
- Linen management
- Waste Management
- OR and SPD related Supply Storage
- Bed Storage and Cart Washing
- Pharmacy related staging and Supply Storage
- Staging space related to pharmacy
- IV storage
- Repackaging and process flow
- Technology related space requirements
- AGVS related staging
- AGVS related charging and other support
- Cost estimates (lease versus purchase) and qualitative analysis of AGVS system
- Assessment of any traffic closer to the new tower and related productivity analysis(in addition to current loading dock areas) such as:
- Pharmacy related transport to outside facilities
- Lab related transport to outside facilities
- Waste stream related traffic
- Maintenance related traffic
- High level assessment of support spaces at patient floors including:
- Any major gaps
- Application of FAT core specific to support spaces
- Recommend next steps and roadmap for detailed design development
- RFQ Evaluation and ROI Analysis for AGVS, Tuggers, and Chutes (December 2008- February 2009)
- Facilitate Logistics Related Design Support (January 2009 – April 2009)
- Lead user group and focus group discussions to address end to end logistics processes (from point of entry of clean materials to point of exit of waste) and develop seamless input to design development (DD) process:
- Material transfer systems and related spaces
- Materials Management and related functions
- Supply management
- Equipment management
- Stat order management
- Linen and scrubs management
- Waste disposal and EVS support<.li>
- Pharmacy related logistics
- New SPD and OR related logistics support
- Patient transport and beds management
- Office supplies, mail and document management
- Support space planning and process design support
- Basement support planning and adjacencies
- Space below tower
- Space near existing kitchen
- Space requirements and planning support for chosen technology alternative such as AGVS and chutes
- Technology implementation planning pilot support
- Detailed process flow design and support space plan for new SPD
- Recommendations were made proposing an annual operational savings of $1,200,000
- Comprehensive Business Case to support Automation Technology using AGVS (Automated Guided Vehicle System)
- Comprehensive design support for storeroom changes
- Design support for last 100 feet supply and equipment space planning
- Design support for Pneumatic Tube System
A 650 bed hospital was in the process of constructing a new patient tower that would provide additional patient beds. The engagement involved the review the logistical processes in place and Reengineering of their existing AGVS system.
- Determine current strengths and opportunities with various materials related processes
- Make recommendations about organization structure, leadership, accountability and authority for distribution operations.
- Devise a distribution operations plan for automated and/or manual material handling systems
- Recommend “quick hit” solutions and savings opportunities
- Architectural designs studied to understand facility layout and service access paths
- Key Performance Indicators (KPIs) developed by us while working with hospital staff and implemented by hospital management
- Automated Guided Vehicle System (AGVS) optimization with an AGVS schedule optimization tool developed for use by the customer to avoid bottleneck issues with future changes in material volumes
- Pneumatic Tube System (PTS) including adjustments to the utilization schedule and system expansion plans
- Infectious waste disposal alternatives
- Elevator simulation analysis to eliminate bottlenecks in operating AGVS system
- Patient care unit supply management strategies
- Materials Management reorganization
- Materials Management labor analysis
- Strategic distribution operational plan development
- Annual operational savings of $900,000 plus one-time automation related savings of $600,000
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