How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful
-
Upload
saskatchewan-health-care-quality-summit -
Category
Healthcare
-
view
212 -
download
0
description
Transcript of How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful
![Page 1: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/1.jpg)
How Organizing Linen & Supplies Turned Morning Care from Frantic to Meaningful
Ngaire Woodroffe Brown, RQHR and Jill Forrester, 3sHealth
www.qualitysummit.ca
#QS14
![Page 2: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/2.jpg)
Faculty/Presenter DisclosureFaculty: [Ngaire Woodroffe Brown & Jill Forrester]
Relationships with commercial interest: • [Grants/Research Support: none]• [Speakers Bureau/Honorarium: none• [Consulting Fees: none]• [Other: none]• No relationships to disclose? Not Applicable
![Page 3: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/3.jpg)
Disclosure of Commercial Support• This program has received financial support from [n/a] in the form of [n/at]
• This program has received in-kind support from [n/a] in the form of [n/a]
Potential for Conflict(s) of Interest: • [N/a] has received [n/a] from [n/a]• [n/a ][developed/licenses/distributes/benefits from the sale of, etc.] a product
that will be discussed in this program: [n/a]
![Page 4: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/4.jpg)
Mitigating Potential Bias• [Explain how potential sources of bias identified in slides 1 and 2 have been
mitigated – n/a]
![Page 5: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/5.jpg)
Before We Begin… Linen & other supplies have a huge impact
Standard work is a powerful tool
Use strong processes, replicate thoughtfully
Communication is vital
The enormity of the improvement to care through something so simple!
The importance of thinking and acting as one
![Page 6: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/6.jpg)
Context: 2 RPIWs March 2013 Potential BiasLinen Infection Prevention & Control throughout its trip through the facility
Housekeeping + Unit 3-5 (Joint Process Owners)
AM Care Routines & Supplies: Unit 2-5 (Process Owner)
Sponsors: Ngaire Woodroffe Brown, Director, Extended Care/Veterans ProgramJim Crawford, Director, Provincial Linen Services, 3sHealthSteve Adkins, Director, Support Services, RQHR
![Page 7: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/7.jpg)
SuccessesDefects Eliminated
Soiled Room 5S• Touches of soiled linen to clean linen bags in soiled room and clean care givers
New Process for Gathering Supplies for AM Care • Touches to linen prior to use • Pre-kaizen - only 16% of linen tracked used in less than 48 hours after exposure
Number of times care givers left the room to get supplies during am care • Pre-kaizen – care givers left rooms 27 times in 2.5 hour time span for 10 residents
![Page 8: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/8.jpg)
But We Weren’t Happy…
Audit Results
9 months had passed
Daily visual management in place
Sponsor had long term replication plan
Commitment from process owners and team members
![Page 9: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/9.jpg)
Replication at Wascana RehabUnit M-5 M-6 2-5 2-6 3-5 3-6
5S Chart Room (as part of RPIW) 5S
5S Clean Supplies 5S 5S 5S 5S 5S 5S
5S Soiled Room RPIW (Joint Start)
RPIW (Joint Start)
AM Care Infection Control RPIW
AM Care Supplies RPIW
Tena Kanban Kanban
Bento Kanban Kanban
Clean Supplies Kanban Kanban Kanban
Replication #1 March 2013
Replication #2May 2014
Replication #4June 2014
![Page 10: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/10.jpg)
Stage 1 Replication: January 2014gating Potential Bias
Care Aides : Willy Aubon, Erica Church and Tammy WatsonKaizen Support: Tyler Chiddenton (MoH), Bob Parker (RQHR) and Jennifer Fetch (3sHealth) Sponsor : Ngaire Woodroffe Brown, Director, Extended Care/Veterans Program, WRC (absent)
![Page 11: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/11.jpg)
Soiled Room 5S
Pre 5S
![Page 12: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/12.jpg)
You Know They Were Keen….
Soiled Room
Replication attempt
![Page 13: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/13.jpg)
Pre-Kaizen Linen Carts• Linen sits exposed and
touched for days/weeks
Cart sits in hall 24 hours/dayOnly 16% of linen used within 48 hours
Care givers going in and out of room 27 times in 2.5 hour period looking for supplies
![Page 14: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/14.jpg)
New AM Care StandardRounding cart prepared each morning then cleaned and put away Defects eliminated:
Linen exposed for minutes/hours Linen touched once prior to resident use Care givers do not leave room during
care
Variation Unit can decide whether to bundle or stack
linen
![Page 15: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/15.jpg)
Tena Kanban
AfterRight amount, right time in right
location. Residents & families aware.
Before Cluttered. Right amount?
At right time? In right location?
![Page 16: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/16.jpg)
Tena Kanban – Our Tena Cupboard
Insert photo of regular products in cupboard Special OrderProducts
Stock / Regular Order Products
![Page 17: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/17.jpg)
Principles for Replication Plan
Use JBA tools and processes
Keep it as simple as possible
Engage team members from original RPIW (“pay it forward”)
Learn from workers on the gemba – update standard work where needed.
Build partnerships – “think and act as one”
![Page 18: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/18.jpg)
Replication Event Agenda
![Page 19: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/19.jpg)
What Happens - Preparation Week1. Kick Off Meeting
Sponsor comments
High level Lean review; Source team talks about wastes removed with new
processes
Fear & expectations with group
![Page 20: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/20.jpg)
Preparation Week cont’d2. Current State at Source & Receiving Sites
Observe new standard work in action
Can’t simply replicate – need to integrate learnings and update standard work
3. Start Data Gathering
Identify 2-3 targets from RPIW target sheet
Gather the data in Receiving site to get baseline
![Page 21: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/21.jpg)
Preparation Week cont’d4. Document Implementation Steps
Build detailed implementation plan for event week• Standard work for implementation• Photos, posters, communications• Measurement tools
5. Communicate
Share plans and results through daily visual management
Tour teams through source gemba
![Page 22: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/22.jpg)
And Then Event WeekMonday
• Reaffirm standard work and prepare for implementation
• Communicate with team
Tuesday and Wednesday
• Implement the new standard work
• Communicate, train, begin post-kaizen data gathering
• Plan audit
![Page 23: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/23.jpg)
Event Week con’tdThursday
Team members go back to work
KPO and TL document, troubleshoot, build report out
Daily check ins with team, sponsors and process owners
Friday: Report Out 1 p.m.
![Page 24: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/24.jpg)
Replication Components
RPIW Stage 1 rep
Stage 2 rep
Build Package for Each Process• Standard work • Standard steps for implementation• Photos, signage and communication tools• Data gathering tools
Stage 2 rep
Stage 2 repReadiness Assessments
Cascading Replication Plan
Reporting and Tracking Audits
Lean Foundation:DVM, VSM
Communication of Plans by Sponsor
![Page 25: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/25.jpg)
Learnings Liked the prep week, event week and report out; add 5S
3 day prep event worked; give at least 3 days for event week (ie. extra day)
Need Team Lead and and Sub Team Lead – KPO can’t do it all
Review current state – there will be changes….
Used waste wheel as starting point for discussion
Engage original team members in replication ( use the “pay it forward” approach)
Invite future replication partners to RPIWs and replication events
Clarify partnership arrangements & roles
![Page 26: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/26.jpg)
Replication Wall
Lastly, keep your “eye on the prize”….
![Page 27: How Organizing Linen and Supplies Turned Morning Care from Frantic to Meaningful](https://reader033.fdocuments.net/reader033/viewer/2022061120/546644cdaf7959e5108b5afc/html5/thumbnails/27.jpg)
Questions?
Contact Us:Ngaire Woodroffe Brown, Director, Extended Care/Veterans Program, WRC or
Jill Forrester, Director, KPO, [email protected] ; [email protected]
www.qualitysummit.ca#QS14