A sustainable system for improving cooperation and patient care on the ward
Hospitals in general are subject to major changes. Economics are often the priority, and as a result good patient care becomes more demanding. The number of treatment cases, and with it their complexity, are increasing, meaning that staff workload increases too. Ward teams have to deal with more sick leave, higher rates of dissatisfaction, and ever-increasing overtime. Doctors and nurses report increased stress against the background of a growing shortage of specialists. The result is a lack of patient contact, higher risk of mistakes, dissatisfied patients, and exhaustion and demotivation in the ward team.
With a Lean hospital ward, scarce time and thin staffing levels are better utilised. With the Lean approach, ward teams can swiftly organise themselves so that processes and cooperation become easier and more effective. Motivation and commitment return, and patients are once again the first priority.
Implementing Lean on a ward means system changes. Several changes take place simultaneously— from the way services are provided, to management, and, finally, culture change. By implementing a system of customised, interprofessional solutions, processes are consistently aligned to patient needs, and a continuous improvement process is initiated.
The consistent focus on the patient pays off, resulting in the following:
- More time to work with patients
- Better patient experience
- Improved interprofessional interaction
- Improved quality in the delivery of services
- More effective leadership
- More commitment from employees, less overload, and less time spent in meetings
- Establishment of a culture of transparency and continuous, independent development.
Adapting proven solutions to individual needs
Throughout the entire process, new and innovative solutions are handled by a project team consisting of employees involved in day-to-day business. walkerproject accompanies the team and ensures that the sustainable change is successful. A typical Lean ward pilot project runs through three phases:
Definition of the problem and the project’s ambition:
- During two days of on-site inspection and observation (Gemba), the project team identifies where potential for improvement lies, defines the target state (the ambition), and collects ideas for solutions. This forms the basis for all further work.
Prototype-based solution development:
- In several workshops, the team adapts its needs and solidifies the previous phases. The working method is inspired by design thinking: create a prototype quickly, test it, and improve it further. During a trial run in a real-world ward, the solutions are tested and refined before their final implementation.
Implementation in everyday work:
- The exciting thing about a Lean ward is that the effects are immediately noticeable when all solutions are introduced simultaneously at the ‘go-live’ time. For this reason, the introduction is based on the ‘big bang’ principle: all solutions are introduced at once. During several reviews, we ensure that the changeover is successful and sustainable. And this is only the beginning—as soon as the system is active it takes on a life of its own, meaning that employees continue to develop, adapt, and improve their solutions and standards beyond the lifetime of the project.
The effect is created by the interaction of the solutions
A Lean ward is a system of 10–25 individual solutions that interlock and only develop their full effect when used together. If you know different Lean wards, you will notice that certain elements are practically always present. But if you take a closer look, you will also find that the actual design of the solutions sometimes differs considerably. There is a simple reason for this: if the solutions are not adapted to the needs of patients and staff and if local peculiarities are not taken into account, the Lean ward will not work. However, the basic idea behind the solutions is the same. Below is a description of frequently encountered solution approaches:
- The huddle is an interdisciplinary and interprofessional short meeting where what is important for the upcoming day is discussed. This allows potential problems to be approached proactively and prevents time-consuming telephone calls for ad hoc coordination during the day.
- The patient board visualises the most important information for the patient at the patient bed and serves as a reminder for various professional groups. When was this examination again? One look at the board is enough.
- The round standard defines how the interprofessional round is conducted. The aim is to achieve the greatest possible clarity for all those involved and a high degree of immediate completion. The patient is included as an active discussion partner. To make all this possible, a common standard, a structured process, and clearly distributed roles are needed.
Just as important as the detailed design of the individual solutions is their interaction: How does a short-term change in daily planning reliably find its way from the huddle to the patient and thus to the patient board? During the workshops, the project team develops not only the visible and haptic solutions but also the processes needed to ensure that everything fits together.
Lean ward pilot project
This is the ideal entry into the Lean hospital world and, with over 50 successful projects, our bestseller. Proof that it works is provided within 4–6 months. After that, nobody wants to go back to the old way of working.
After some pilot wards have been implemented, the new system’s rollout has to be tackled. A good balance between implementation and learning speed and between individuality and standardisation is crucial. We bring our experience and coach the internal implementation team, initially intensively and in the longer term more selectively.
Lean ward refresher
Continuous development is a core element of Lean. This mini-project is about ensuring the changeover’s sustainability and introducing new ideas and solutions.
Do you want to learn more?
Would you like to learn more about lean wards? We would be delighted to tell you more about our project work in an obligation-free conversation or answer any questions you may have. Our team is looking forward to hearing from you!