Quarterly Lean Review

Back to school ads remind us that students will soon be back in class and another school year will begin. For Saskatoon Health Region, learning is a year-long event, as we continuously strive to improve our care and services and the skills of the dedicated staff who deliver them.

Maura Davies, President and CEO, Saskatoon Health Region

Maura Davies
President and CEO
Saskatoon Health Region

We continue to experience increased demand for our services, placing considerable pressure on our dedicated staff. One way we are striving to cope with these service pressures is adoption of lean and the use of lean tools and methods.

Part of our lean management system involves extensive training in tools and methods to help us improve quality, safety and eliminate waste. All staff are expected to attend our one-day lean training called Kaizen Basics, and hundreds of staff are enrolled in lean leader certification.

On a quarterly basis, our progress on adoption of the lean management system is formally evaluated by our lean consultants and we receive a report card. In 2012 we established a new organizational structure that includes service lines which represent a cluster of related services. Last month four service lines were reviewed:

  • adult medicine and complex care (includes medical units, critical care, emergency departments and renal services);
  • maternal and child health services;
  • surgery; and
  • support services (includes housekeeping, laundry, materials management and other non-clinical services).

The review involved presentations by service line leaders on their quality improvement work and visits to units and departments (gemba walks) to see how staff are using daily visual management and team huddles to improve their care and services.

Like school report cards, criteria are reviewed that tell us how well we understand and are applying the new tools and methods we are learning. The review examines 15 criteria, including adoption of 5S to create a well-organized workplace, standard work to ensure consistency in how work is done, kanban (a signal system and way of managing supplies that ensures just in time delivery of supplies), and use of visibility walls and team huddles to embed problem solving and continuous improvement as part of daily work.

So how are we doing?
On a scale of 0-5, our service lines received overall scores of 1.3-1.5. We received our highest scores related to adoption of 5S, daily visual management, standard work in medicine and maternal/child service lines, and kanban in support services. Areas where we have significant opportunity to continue to improve include mistake proofing our processes to eliminate defects and harm to patients and staff. We also have opportunity to improve how we understand our supply and demand for services and align resources to better match service needs.

In all four service lines we saw notable progress compared to January 2013, when service line scores ranged from 0.6-1.5. Organizations that have adopted lean for many years usually see scores in the 2.5 range, indicating we are well on our way, thanks to the hard work of many people and our commitment to learn lean and continuous improvement.

In addition to service line scores, we are assessed on our progress organization-wide, including the development of our Kaizen Promotion Office. There are 28 criteria related to various aspects of the Saskatchewan Lean Management System, including weekly regional wall walks to review key performance measures, use of data to inform improvement work, problem solving that results in organizational learning, and linkage between organizational strategy and improvement work. Our overall score was 2.8 compared to 2.2 in January 2013. This is impressive and indicates that although we still have a long way to go, we are making very good progress, especially for such a large and complex organization.

Evaluation of our progress on adoption of the lean management system is only one way in which we measure organizational performance. At the end of September, we will have a site visit by Accreditation Canada surveyors to assess our compliance with national standards and required organizational practices to support patient safety. The clinical outcomes we achieve and the satisfaction of our patients, clients and residents are ultimately the best measures of our performance. All of these performance measures are related and provide us feedback on how well we are doing and where we have opportunity to continue our learning as we go “back to school” and learn.

What are you most proud of and where do you feel we need to improve?

As always, I welcome your views. I can be contacted directly at maura.davies@saskatoonhealthregion.ca.

Maura Davies
President and CEO
Saskatoon Health Region