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Our health system recently launched a process improvement program, mainly using Lean Six Sigma methodologies. I am looking to share experience, ideas, and advice with other hospital based organizations on financially quantifying such projects and initiatives.

I have found it to be rather challenging to financially quantify projects where there isn't a strong cause and effect relationship. An example is reducing supply and equipment shortages in the OR (which may impact first OR case delays as well as many other delays). Besides potential overnight shipping charges and case cancellations, the other potential benefits are very "soft" such as....saving staff time "searching" for missing items which also has not been easy to quantify.

Has anyone experienced such a situation and/or available to speak with to share advice?  

One of the side effects of studying supply and equipment shortages is that you often find that you have too little of the things you need and too many of the things you don't.  Reducing the inventory of things that you don't need can result in significant savings.  If you are able to impact first OR start delays and can regularly fit in additional cases and/or reduce length of stay, you should be able to measure the financial impact of these results. 

 I would be happy to talk with you more about this, if you are interested.

 

My facility did an entire VSA on the Central Processing department, including a rapid improvement event on this very topic.  What I found was two fold: 1) we eat away at our savings in healthcare-based Lean initiatives by not reducing the FTE when a workflow improvement decrease the number of worked hours in the department.  If any part of your solution set decreased your takt time (as is inferred by saved time "searching"), quantify that and eliminate or transfer the saved FTE. 2) You're focusing on the immediate impact because you are new to the process.  Once you've been at this for a while, you'll have more value stream/process flow maps that help visualize what happens before and after the process you are investigating.  As we moved along in our VSA, we found that the shortages in equipment caused a great number of more wasteful 'quick cleans' to get the tray from the last similar case turned over.  Quantify that, and you'll see real savings by increasing standardization.

 Hope that helps, EJD

Some of the advice you're getting is right on; some is "soft cost" advice. Here you go -- must quantify a direct reduction in the cost center(s) in the change process and/or the additional revenue from freed-up capacity that will begin ON THE DAY THE PROJECT ENDS. Many want to state "additional capacity that can accommodate additional surgeries", etc. That won't work & the CEO/COO/CFO will bale after about a yr. If revenue, project results get COUNTED on the day the new revenue begins; if revenue is only "hope", go for decreased staffing. A hard message, but the only ethical one to pursue. Good luck with your efforts.... Chip

I have experience particulary in the OR.  Would like to hear more about how your efforts are panning out.   

The measureable waste we found are all the cost avoidance scenarios such as:

Inventory par management, labor waste that includes looking for items during and in between cases (using turnaround time changes as a metrics),  parallel process pre-operatively that saved in significant Tech and RN usage in the Same Day and PAT area (was not hard to quantify) and well as reduced patient waiting time before surgery by 65 minutes.  What helped us is that we already had all the baseline info before our lean six sigma efforts so we could see all the significant changes very clearly.    We also used Lean to reduce energy, water  and overall costs associated with environmental impacts.  

 

Kristin

 

If I may add to this.... when we reduced FTEs as a result of a VSA we began inventing value positions to improve patient outcome and experience since the trajectory of payment is going to be on value anyway.  Some examples were an outcomes manager, service line strategist such as a joint coordinator, a patient liason (former OR RN) that helped boost our patient satisfaction scores etc.    I think it is important to institute a "no lay" off policy when embarking on lean six sigma efforts.  If staff are motivated they will add value and we know with the complexities of healthcare we could use all hands on deck.