Specific set of tools and methods designed to rid the workplace of insufficiency and waste
What is Lean?
100
Signboard - contains key information about how much of an item is needed and helps indicate when items need to be ordered
What does Kanban mean?
100
A second by second review of daily work activities. Can include videotape of activities in a 30 minute period that are later analyzed and broken down to pick out areas of improvement.
What is full work analysis?
100
* Should be held at the beginning of every shift and attended by all members of the care team
* Last no longer than 5-7 minutes with all parties standing
* Helps anticipate work load for the day
What are huddles?
100
I am the author of the book.
Who is Michael Nelson?
200
Implementation phase and Sustainment
What are the 2 phases of lean?
200
Evenly spreading out the demand for production throughout an established time period.
What does Hijunka mean?
200
* Clear starting and ending point
* Adds value to the patient
* Looks at current state and how to change
* Check-in
* Exam Prep
* Exam
* Education
* Check-out
What is value stream mapping?
200
* Real time monitoring of changes made
* Should be performed by supervisors
* Should be done on weekly even daily basis
* Should not be used to find fault in employees
What are assessments?
200
* Assess site's beliefs, values, and culture prior to implementation phase
What is a culture survey?
300
Overproduction, waiting, transportation, inventory, motion, over processing, errors and waste of talent.
What are the eight deadly wastes?
300
* part of sustaining a lean environment
* should be regularly scheduled
* learning place
* continually performed to evaluate results of implementation phase
What is the purpose of Gemba walk?
300
Sort - going through all items in workplace and removing those not used regularly
Set in order - determine ideal location for supplies, equipment, etc.
Standardize - Make all work areas the same
Shine - keep work area clean and clutter free
Sustain - Continually audit area to make sure changes are maintained
Safety - Make sure work area is hazard free
What are the 6S of the implementation phase?
300
* leader standard work
* visual controls - huddles, Kanban "sign board"
* Daily accountability
* Leadership discipline
What are the fundamental elements to sustain lean?
300
* Describe 3 things that site is most proud off
* Describe reason for Lean and compare to current goals
* Describe current leadership status
* Describe current or planned projects for company
* Describe current beliefs about improvements
* Describe the current decision making process
What is the pre-Lean assessment?
400
Toyota
What company model is Lean based on?
400
* "take apart" and "make good" (p. 23)
* In textbook used to "refer to a time-limited event focused on a particular process or problem" (p. 23)
What does Kaizen mean?
400
* Used for continuous improvement
* Includes data gathering, determining root of cause
* Determine was to correct problems and implement
* Continuously Observe and Review results
* Modify as needed
What is Plan Do Study Act?
400
* Lies with managers and supervisors
* Coaches and mentors to others
What is ownership?
400
* Lack of participation
* Subtle sabotage
* Failure to adapt/adopt changes implemented by Lean
* Plays favorites
What are problematic behaviors?
500
* Patient is physically or emotionally changed
* Patient willing to pay for
* Performed correctly the first time
What is value added?
500
First-in, First-out - for inventory purposes or in terms of patient: the patient waiting the longest should be seen first
What does FIFO mean?
500
* Need to have physician on board and taking a leadership role
* Includes:
* involvement in creating vision and goals
* reward and recognition
* setting expectations
What is physician engagement?
500
* Can take 12-20 months
* Requires continuous monitoring
* Visual controls
* Adherence
What is success of Lean?
500
" A lean healthcare organization trains people in problem-solving, then respects their opinions and experience enough to let them take the lead on improvement."
John Toussaint, MD