Implementation of Best Practices in Environmental Cleaning using LEAN Methodology Tom Clancey and Amanda Bjorn
Why Change?
How What is LEAN? Lean is a set of concepts, principles and tools used to create and deliver the most value from the customers perspective while consuming the fewest resources
From the customer s perspective, Everything we do either: adds value or does not add value
Value Added Any activity that directly contributes to satisfying the needs of a customer Non-Value Added Anything that consumes time or resources but does not add value
Most processes are NINE parts waste ONE part added value
Focus of Improvement Improvement will be better if we focus on the non-value added activities (waste) 10% Value Adding 90% Non-Value Adding
Going to the Gemba Time Observations to eliminate key waste, tools you for must seeing be able waste to see it Spaghetti Diagram Current State Process Diagram
Things we looked for: defects
waiting
processing waste
unnecessary motion
Time
LEAN is all about There can be no making things growing without people making people -Toyota
What we did
First, we started with the Time study
Time to clean Office areas + Time to clean Patient areas = Not enough time in one day We discovered
A TALE OF TWO CITIES ZONES. GREEN ZONE RED ZONE
Reason for Action We don t have enough time in the day to do the cleaning work we need to do. We do not always meet the best practice standards for infection prevention and control with our current housekeeping methods in patient rooms. As a patient, I don t want to acquire an infection during my stay at Providence Healthcare.
Current State and Target State Times per week finished office cleaning before 8:30 am Current State Unknown Target State 4 days / 5 days Nosocomial Infections A5 in the past 6 months % time spent cleaning patient rooms 1 0 66% 85% PIDAC standards exist for cleaning patient rooms. We do not have standard work or work instructions for our housekeeping activities at Providence Healthcare. The majority of waste in housekeeping activities exists off of the patient units.
Target State We have Standard Work and Work Instructions for all housekeeping activities that occur in patient rooms. To decrease the waste and increase the value-added time for the patient. As a Housekeeper, I know when my cycle time will exceed my available time for that day and I have the ability to stop the line as soon as this is known. As a patient, I know that my room at Providence Healthcare is clean.
Gaps We have not fully implemented the PIDAC best practice standards for cleaning. We do not have the time to finish our work, let alone create the capacity to perform best practice. We have no way to know or respond when we fall behind in our housekeeping duties.
Solutions to Try If we have standard work, then housekeeping duties will follow best practices and be predictable/repeatable by all. If we simplify the flow of the housekeeper s day, then we will reduce wasted time and increase the time the housekeeper can spend in the patient areas (red zones). If I know my threshold exceeds my time available then I can stop the line and get help to finish my work.
What we did
What we did Visual Standard Work for Cleaning Patient Rooms
What we did Ability to Stop the Line if we are Running Behind
What we did Decreased time spent in office areas (Green Zones)
Implemented Daily Checks to see how the process was working
Outcomes 81% of time now spent on cleaning Patient Areas Still needed more resources
Sustain the Change Spread the Change to Other Units
Insights form the Team Powerful to have front line at the table and making the decisions. Privileged, grateful, learned and will support you guys. If we all work together, we will be powerful. Proud to be here. Increased my own awareness of how important we are to the team. How important we are for our patients. Look at things differently. Really appreciate all of housekeeping s hard work. I will take my pear core to the kitchenette. Even the little things make a difference. Making the day more important for patients and staff.
Insights form the Leaders This is the first time we have spread such an extensive and complex change so quickly The change is being sustained to this day