Prairie North Health Region continues to "LEAN in the Right Direction" in eliminating waste, creating value and improving efficiency in its health care services and programs, according to a press release.
"LEAN in the Right Direction" is the slogan PNHR has adopted for the region's journey into Lean, a quality improvement initiative that has been ongoing in Prairie North since fall 2009. Fourteen Lean projects are active in the region covering a multitude of departments and areas including scheduling, renovation planning, laundry services, discharge planning, emergency departments, surgical planning, workplace wellness and
One of the Lean projects at Battlefords Union Hospital (BUH) has made a significant impact in lowering overtime costs associated with scheduling. Members of the BUH scheduling Lean team mapped out the entire scheduling process and identified practices and issues that made scheduling for nurses an inefficient and costly exercise, the release states.
"The team discovered that gaps and inconsistencies existed in the scheduling process," says Jody Davidson, PNHR Quality and Safety director. "Gaps in staffing and rotations caused a process called 'pre-booked overtime' where employees were booked for overtime as a preventative staffing measure in case of shortages."
Other issues included inconsistent use of and employee access to an electronic scheduling system (ESP), and use of a manual time book which increased errors and confusion between the paper system and the ESP system, and increased claims for missed meal breaks, Davidson explains.
"The solutions the team came up involved some standardization of practices and a few changes in the scheduling process," she adds.
"For the health and well-being of our patients and staff, the team recommended that the region discontinue the practice of paying out missed meal break claims. The team believes it is more important for staff to take their scheduled breaks to ensure that they take care of themselves with proper rest and nutrition, so that they can continue to deliver quality care to patients."
Other improvements included ensuring every scheduler was trained to use the ESP system properly and doing away with the manual (paper) time book to ensure consistency and reduce errors. New staffing rotations were created to fill the gaps and to use "float" staff properly and effectively, eliminating the practice of pre-booking overtime.
"By examining the entire scheduling process from beginning to end, the team discovered ways to make the process more efficient and effective," says Davidson. "Through the team's recommendations, the region has been able to save over $220,000 annually, and has been able to re-invest that money into bolstering programming and supports."
PNHR is also applying Lean concepts to renovation projects across the region. The process directly engages frontline staff by getting their input on their workspace and how best to optimize the flow of patients, staff and information.
"Because of the staff input, we usually come away from the process with a completely different floor plan than originally designed but one that works better in terms of caring for our patients," says Davidson. "As an added result, we maximize our renovation dollars and create a more functional space for our patients, clients, residents and staff."
The first space to undergo the Lean renovation treatment was the Lloydminster Emergency Department, plus the Laboratory, Diagnostic Imaging and Admitting departments, as these departments impact the ER's flow and efficiency. Members from all departments participated in the process as they performed a "5S", which stands for Sorting, Straightening, Shining, Sustaining and Standardizing. A 5S exercise optimizes organization, cleanliness, and sustainability.
The results of the 5S were organized and labeled storage in the supply rooms, the creation of a centralized location for medications, and colour-coded stock indicators for easy storage and ordering. The team also recovered unused inventory which resulted in financial savings of approximately $4,200.The 5S exercise assisted the team in determining the best possible use of space in the emergency department which factored heavily in renovation planning.
"PNHR's success in Lean initiatives is directly attributed to the dedication and hard work of our employees who not only want to find ways to do their job more effectively and efficiently, but who also strive to add value to our patients', residents' and clients' experiences in health care, " says Davidson. "None of what we've achieved could have been accomplished without staff participation and commitment."
