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Lean implementation in Cypress Health Region a work in progress

Written by  Matthew Liebenberg

The Cypress Health Region is confident the implementation of Lean in the region will not slow down when the provincial consultant’s contract ends at the end of March.

The Saskatchewan Ministry of Health announced  Dec. 29 the contract with Seattle-based John Black and Associates to facilitate the implementation of Lean-based practices across the provincial health system will end three months earlier to reduce costs.
The contract was supposed to run until June 2015, but instead it will conclude March 31.
Cypress Health CEO Beth Vachon said there was always an understanding the John Black contract would eventually come to an end.
“So we’ve been very thoughtful about what it is we needed to learn and do in order to become self sufficient,” she mentioned. “The fact that the contract is going to be ending three months sooner than what we had anticipated really doesn’t change the work that we’ve been doing to create capacity within our region to be able to continue doing this work.”
A total of 24 Cypress Health staff members have already received Lean training. Eleven of them are fully certified and therefore able to lead Lean events.
“We do have a group of people within our region, four or five people, who have gone through all of the Lean certification training and have met all of those requirements, but then have taken further training as the people within our region who actually work with the teams as they’re doing the improvement work to ensure that we’re using the tools properly, that we’re getting the kind of information that we need, that we’re scoping the projects properly,” she said.
Cypress Health has also used a one-day training program, Kaizen Basics, to provide other staff members with an introduction to the theory and tools of a Lean management system.
On a provincial level there have been discussions about providing health-care staff with training that is more advanced than the Kaizen Basics training, but not as rigorous as the training for full Lean certification.
“We’ll be looking at opportunities over this next year how we start to incorporate some different training that we’ll run ourselves within the region to move people to just that better level of understanding in how to actually use the tools and do that daily improvement work at the point where they work,” she said.
According to Vachon the health region’s improvement plan for the year will be reviewed in coming weeks to evaluate any potential implications from the conclusion of the John Black contract.
“I have complete confidence in our region and the people who have taken this training to be able to continue on the path of quality improvement and safety,” she said. “I just don’t see that changing. Those values are embedded in our region and this really just keeps us focused on the tools that help us to achieve that.”
After March, the Saskatchewan Health Quality Council will continue to provide support with the use of Lean methodology through its role as the provincial Kaizen promotion office. In addition the health regions will co-operate and provide support to each other with the implementation of Lean methodology.
“Often when we’re doing improvement work we may have people from other regions who are coming to learn with us, participate, get experience and then of course that supports the work that we’re doing in our region,” she said. “We’ve had our staff going to other regions to learn, to participate and offer that support and expertise and knowledge in other regions. So I don’t see that changing. … There’s a real willingness and commitment to support each other through establishing this as our management system.”
Vachon mentioned the Cypress Health Region has already seen some significant improvements from using Lean tools, but emphasized the focus has never been on financial savings.
“There seems to be a sense that this was all about saving money and when we embarked on this as a province it was never about saving money,” she said. “It was always about patient safety and ensuring that when people come to the health system that we don’t harm them and that was the driving force behind this.”
As an example, she referred to a Lean event at the Cypress Lodge long-term care home in Maple Creek that reviewed the medication delivery system.
Nursing staff were spending at least 50 per cent of a 12-hour shift to prepare and distribute medications to care home residents.
“We knew that in that day a nurse would pass 448 medications in a 12-hour shift,” she said. “So what we know with that is when you’re handling and managing and spending that much time, what that can sometimes lead to is missed medications or medication errors or not having time to do the other kinds of things that we need our nurses to do.”
The community pharmacist participated in this event, which resulted in the implementation of a just-in-time delivery system for medications. Instead of stocking the full monthly supply of medication on carts that filled an entire room, the medications are now delivered weekly.
“We went from 665 medication carts to 110, so that’s a big reduction,” she said. “We were actually able to save over four hours a week just on the re-ordering process the nurses were doing. We saved about an hour a day in the medication prep and administration.”
Another change has been the implementation of regular multi-disciplinary meetings between nursing staff, the doctor and pharmacist to review the supply of medications to residents and where possible to change the issuing of medication from four times a day to two.
“What that did was free up some time, ensure the people were on the right medications, that they weren’t taking as many medications potentially,” she said.
These improvements did not result in direct cost savings for the health region, but the long-term care home residents benefitted financially because they only need to pay for a weekly supply of medication. Previously any change to their medication after the start of the month would have resulted in a financial loss to them because they have already paid for their monthly supply of medicines.
The three capital projects in the health region for a new integrated healthcare facility in Maple Creek, a new long-term care facility in Swift Current and an integrated facility in Leader are creating additional opportunities for applying the principles of Lean.
Vachon noted staff who have been actively involved with Lean implementation and improvement events in the health region can clearly see the benefits of this approach.
“It is interesting that often times when people aren’t actively involved in something they have a hard time supporting it because they don’t necessarily understand the theory, the rationale on how the improvements get made,” she said. “I’ve never heard anything negative from staff members who have actively participated in improvement work that we’re doing.”

via SW Sask News – Prairie Post – Prairie Post

One Reply to “Lean implementation in Cypress Health Region a work in progress”

  1. Jim Beswick

    Manpower reduction here owning to the lean process may not be such an advantage, but surely there is going to be a tremendous change in the waste management. Using lean I presume it will be easier to manage – since work instructions and medication supplies will reach the end point smoothly and quickly. Of course, as explained, problems will arise during the course, but these will be much easier to handle and solve.

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