This document discusses Lean operations and how its principles can be applied in non-manufacturing environments. It defines Lean thinking, outlines its history and key concepts, and provides a case study of how Virginia Mason Medical Center successfully implemented Lean in a healthcare setting. The document explains how Lean was used to stabilize processes, standardize workflows, simplify tasks, eliminate waste, and continuously improve operations, resulting in significant benefits like reduced costs, errors and waste.

1. Seeking Perfection: Lean Operations in Non-Manufacturing Environments

3. This Is Not the Lean We Are Talking About

4. What Does the Boss think Lean Is? Is it cutting corners? Is it fewer people? Is it working harder? Is it making less?

7. Why Apply Lean? Impact of Lean Operations on Industry 11/02/09 Fertuck Enterprise Directions - 248.881.3244 - doug@fertuck.com - www.fertuck.com *Source: Virginia Mason Medical Center Validated Historical Industry Averages* % Changes Direct Labor Productivity Improved 45-75 Cost Reduced 25-55 Throughput Increased 60-90 Defects and Scrap Reduced 50-90 Inventory Reduced 60-90 Space Reduced 35-50 Lead-Time Reduced 50-90

8. History of Lean

9. Before Lean

10. After Lean In Modern Auto Assembly Plants

12. Scope of Lean Operations Can Vary

13. Learning how to stabilize , standardize , and simplify business processes using the power of the Toyota Production System The Lean System

19. Design the Production System to Optimize the Seven Flows of Medicine

21. Example: Nursing Cells “ Less nursing time provided to patients is associated with higher rates of infection, GI bleeding, pneumonia, cardiac arrest and death.” Keeping Patients Safe: Transforming the Work Environment of Nurses - Institute of Medicine 2004

22. Nurses’ Workshop Ideas

24. Nursing Cells: 90 day Results Metric Before After RN # of steps 5,818 846 PCT # of steps 2,664 1,256 Completion time for AM work cycle 240’ 126’ Patient dissatisfaction 21% 0% RN time spent in indirect care 68% 10% PCT time spent in indirect care 30% 16% Call light on between 7a-11a 5.5% 1%

37. Stabilize – 5S

38. Example of Applying 5S: The Computer Desktop Action Example Issues Sort Cluttered desktop; files everywhere Set in Order Inconsistent folder structure Shine or Scrub Old and obsolete files retained Standardize Each worker has his or her own folder scheme Sustain No audit system

40. Value Stream Mapping: Example of Current State

42. Value Stream Mapping: Example of Current State

44. Value Stream Mapping: Example of Future State

46. If the “Horse Doesn’t Drink”, You Have Nothing

47. Three Elements of Success Water Lead the Horse Drink Situation Technique Behavior Opportunity Process Commitment Nikes Athletic Skills Just Do it! Tools Method Action

48. Thank You!