IFD and the use of a “Lean Boot Camp”

– driving knowledge early to support the design process for two hospital buildings

By: Doug Dulin, JWA Engagement Leader

The Chief Executive Officer at Children’s Hospital Michigan (CHM) engaged JWA’s help and support on two design projects at his organization. The first project is an ambulatory specialty building that helps to meet the needs of a growing market in and around Troy, Michigan. The second is a design of a critical care tower, which enhances the infrastructure of the hospital’s main campus in Detroit, Michigan. To support this pediatric hospital, JWA employed a strategy called Integrated Facility Design, which is a Lean hospital design process utilized at multiple JWA client sites.

Using Integrated Facility Design (IFD), JWA clients have achieved significant results: reducing patient lead-times within an ambulatory clinic, reducing construction costs in a capital building project, and allowing projects to be completed early or on-time. As our clients moved into the new buildings and layouts, they have already achieved improved patient and staff satisfaction scores and have realized continued success around reducing patient lead-time. These were the exact results that CHM was hoping to achieve.

As JWA came on board, we learned that CHM had an initial understanding of the Lean principles we were expecting them to employ. Hospital leaders and clinicians had a general knowledge of how Lean principles could be applied to their design projects. To further educate the design team members, JWA facilitated a “Lean Boot Camp.” Attendees learned how Lean principles are integral to the IFD process and pivotal to the next six-months of their own design process.

This video details some of the improvement explored in the “Lean Boot Camp.” As Dr. Tonya Touchstone says, “It’s better to get everybody involved. Everybody participating. Everybody in the same mindset of what we need to do for the Lean process.” This is part of what makes IFD special; we involve the opinions of all stakeholders in the design process.

Visit www.childrensdmc.org/troy for more infomation about this project!

Learning from the “Lean Boot Camp” allowed the hospital team members to realize significant results, similar to other JWA clients who have used IFD. Department teams were able to reduce room requirements from the initial numbers developed by the architectural program model. Through value stream mapping sessions and into the Integrated Design events, teams were able to achieve lead-time reductions while testing and improving the eight flows of healthcare. Lead-time reductions will allow their patients to reduce their walking from the check in to the checkout process. The matrix below highlights significant results in one of the building projects.

Lead Time Review

The hospital understands that Integrated Facility Design is only 50% of the equation. The CEO and other hospital leaders agreed the work completed through the IFD process would be the catalyst for the organization’s Lean transformation work and standard work development implemented in all hospital departments. Currently, JWA consultants are on location supporting in the development of level clinical schedules, leader standard work and more in-depth knowledge around the use of lean principles.

As the face of healthcare changes, a hospital design process should change as well. In 1995, JWA Consulting pioneered the implementation of Lean with healthcare systems. Now, we are leading the application of Lean design for healthcare facilities. This is what we are calling “Integrated Healthcare Design 2.0,” which will begin to further transform the way we think about lean hospital design.

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