1st Edition

Mapping Clinical Value Streams

By Thomas L. Jackson Copyright 2013
    124 Pages 202 B/W Illustrations
    by Productivity Press

    124 Pages
    by Productivity Press

    Tens of thousands of patients die unnecessarily every year as a result of errors and defects in our healthcare processes. Those that survive often pay too much for the privilege. The value stream mapping methods described in Mapping Clinical Value Streams will help you achieve more efficient health care processes and will pave the way to an improved medical system with significantly reduced medical errors and other costly waste.

    Part of the Lean Tools in Healthcare series, this user-friendly book will help you understand how to use value stream mapping to provide quality, patient-centered care. Value stream mapping is a powerful tool for observing and depicting processes as they truly are—and for envisioning and reconfiguring the same processes to eliminate errors and other waste. With this book, you’ll learn how to:

    • Map current-state processes
    • Create a future-state map with processes streamlined through "flow" and "pull"
    • Manage the rollout of your future state with "A3" project plans

    Presented in a highly organized and easy-to-assimilate format, the book includes examples from actual healthcare processes, plus numerous illustrations and margin assists that call your attention to key points. Value stream mapping icons make it easy to see and understand the ebb and flow of healthcare processes. Each chapter also includes a summary for quick review. Throughout the book you will be asked to reflect on questions that will help you apply these concepts and techniques to your own workplace.

    To be competitive in today’s marketplace, you cannot afford to leave processes unexamined, or let them become haphazard. You must apply conscious, quality attention to continuously see and fix your healthcare processes. In Mapping Clinical Value Streams, Shingo Prize-winning author Thomas L. Jackson shows you how.

    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