I had the privilege of going to the “Gemba” which is where value is delivered to customers at Seattle Children’s last week. What I saw gave me hope.
Seattle Children’s has been on the lean journey off and on since the late 1990s. They re-committed to this journey about 5 years ago. There is clear evidence from the president to front line doctors that the tools and philosophy of lean are embedded in the culture.
We visited the recently opened Bellevue ambulatory care center and saw the results of an ambulatory care process designed elegantly around the needs of the customer. The anesthesiologist medical director explained how the surgical process is designed. The patient comes off the elevator on the second floor and is immediately greeted by the registrar who electronically signals to the doctor and nurse the patient and family has arrived. Waiting less than 5 minutes (they have data) the child and family are escorted through a door and walk about 20 feet to the induction room where they are made comfortable, vitals are taken etc. The anesthesiologist comes into the induction room directly from the O.R., which is connected to the induction room. He then answers any questions the family and patient has and begins the anesthesia induction. The family is with the child through the entire induction process and watches the child as she is wheeled into the directly connected OR. The family is then escorted out of the induction room to the recovery area which is connected on the opposite side of the operating room. When the surgery is complete the child is brought into recovery with the family and wakes up with the parents at her side. Any questions are answered by the surgeon before the surgeon's next surgery begins. As the child awakens she is comforted by her parents and a recovery nurse. Once fully awake and checked one last time by the surgeon the child is taken by wheelchair out of the recovery room another 40 steps or so to the elevator they came up. Down to the first floor and another 20 steps to the car that is waiting under the canopy.
Frankly this is the best “one piece flow” for ambulatory surgery I have observed anywhere in the world. The thought put into this design from a registration, nursing, anesthesia and surgical process perspective is a marvel. The staff at Children’s think so too, as now, all the doctors and nurses who haven't had a chance to work there are clamoring to do so.
Children’s is a great example that lean is working in healthcare. The tight connections developed at Children’s ambulatory care center have created one piece flow for the customer that has reduced cost, improved productivity, and led to higher patient satisfaction. From what could tell the staff loves working there as well. Therefore all outcomes expected from lean have been achieved.
Congratulations to Seattle Children’s!
Leave a Reply