Getting Started
The Purpose of This Book
What This Book Is Based On
Two Ways to Use This Book
How to Get the Most out of Your Reading
Become Familiar with This Book
Become Familiar with Each Chapter
How a Reading Strategy Works
Using the Margin Assists
An Overview of the Contents
Chapter 1: Getting Started
Chapter 2: The Production Processes and Operations of Healthcare
Chapter 3: Value Streams and the Mapping Process
Chapter 4: Map the Current State
Chapter 5: Map the Future State: Phase I—Flow
Chapter 6: Map the Future State: Phase II—Pull
Chapter 7: Implement the Future State
Chapter 8: Reflections and Conclusions
The Production Processes and Operations of Healthcare
The Industrial Origins of Lean Healthcare
Production, Process, and Operation
Principles of Lean Healthcare Management
Standard Work
Autonomation
Flow Production
PDCA
Socratic Method
Summary
Reflections
Value Streams and the Mapping Process
Mapping Clinical Value Streams
What Is Value?
The Seven Wastes and the Purpose of Value Stream Mapping
Patient as Customer versus Participant
What Is a Value Stream?
The Value Stream Mapping Process
Using Value Stream Mapping Icons
Summary
Reflections
Map the Current State
The Power of Direct Observation
Building a Current-State Map
Choose a Service Family
Identify the Patient
Walk the Value Stream and Gather Data
Identify Sequential Operations in the Process
Identify Operational Metrics
Identify Waits between Operations
Document How Work Is Prioritized
Identify Manual and Electronic Information Flows
Identify External Patient Flows
Build a Process Time Line and Calculate Summary Statistics
Another Example
Summary
Reflections
Map the Future State: Phase I—Flow
Principles of Flow Production in Healthcare
Building a Future-State Map with Flow
Produce Services to Takt Time
Eliminate Waits to Flow the Process
Create Continuous Flow with Clinical Cells
Summary
Reflections
Map the Future State—Phase II: Pull
Introduction
If You Cannot Flow, Pull
Link Separate Processes with FIFO Lanes
FIFO Lanes and Reaction Plans
Where to Use FIFO Lanes
Is FIFO Consistent with Patient Safety?
Pull Production with Buffers
When to Use Buffers
Examples of Buffers
Push Me, Pull You
Pull to the Pacemaker
Level the Production Volume
Level the Case Mix
Summary
Reflections
Implement the Future State
Focus
Loop the "Loops"
Hoshin Kanri, A3-Ts, and PDCA
Plan: Write an A3-T for Each Loop
Do: Conduct Kaizen Workshops
Check and Act: Develop Leader Standard Work
Where to Begin?
Summary
Reflections
Reflections and Conclusions
Reflecting on What You Have Learned
Applying What You Have Learned
Possibilities for Applying What You Have Learned
Applying Value Stream Mapping in Your Organization
Your Personal Action Plan
Opportunities for Further Learning
Conclusions
Appendix
Further Reading about Value Stream Mapping
Further Reading about Lean Healthcare
Useful Websites
Biography
Thomas L. Jackson
