Teresa Wilson
Designing a Lean Event that Fits your Healthcare Project
by Teresa Wilson
Designing healthcare projects can be a fraught process; time is tight, money is always a factor, and there never seems to be enough space to do what you want within your budget. How do you deliver patient-centered care while fostering collaboration, maximizing resources, and allowing flexibility for future innovation? Many organizations look to Lean Design to help navigate this process.
Lean is a methodology for producing a product or a service that provides value for the customer in the most efficient, least wasteful way. A lean organization understands it is a long-term commitment, requiring involvement and support by everyone to promote continuous improvement. Steffian Bradley Architects (SBA) and our strategic healthcare planning group, Sterling Planning Alliance, are passionate about incorporating continuous improvement within our own firm, and we are enthusiastic about sharing our experiences with clients as we craft Lean Events to fit within the culture of their organizations. There are multiple types of Lean Events that can be utilized to create better outcomes.
Baystate Medical Center south wing fit-out / Robert Benson Photography
Lean Kaizen Blitz SWAT Events
Intensive one-week events: This approach embeds the planning team within the client facility to produce high-level campus master plans. The team’s onsite dedication and focus provide an opportunity to quickly assess how well the physical plant and site support hospital priorities for patient care, staff, clinical, and support services. As the SWAT event progresses, options are vetted with the hospital senior leadership group for go/no-go status. During the report-out, direction is given to further develop selected options. This type of event is a good fit for organizations that want a big picture look at the constraints and opportunities for targeted growth or reallocation of space.
Lean Operational Analysis
When an organization needs to understand its current operational state, data analysis, interviews, and observations can be used to evaluate the utilization of current resources and recommend solutions. As part of a Lean Event in an academic outpatient clinic, Sterling reviewed exam room throughput data and held events with check-in/out staff to create standard protocols while SBA shadowed staff during patient encounters to determine the best place to allocate resources for medical assistants. These types of Lean Events assist organizations in analyzing operations and can help determine if solutions can be found through operational changes or if additional resources are needed.
Lean 2P Events (Process Preparation)
These are week-long events for creating change in an organization using Lean tools to understand initial and target states. Events are held with teams of representative staff at all levels and patient volunteers to produce an outcome where everyone performs at the top of their license for optimal patient care. Each event builds on lessons learned from its predecessors and becomes a means for validating assumptions and continuous improvement. Lean 2P events assist organizations to harness the creativity and knowledge of diverse groups to create widespread cultural changes in how healthcare is delivered.
Integrated Project Delivery Process (IPD)
This is a design and construction delivery process with early collaboration from the owner and design team utilizing a target-value-design process for effective decision-making within one inclusive contract and cost sharing between the owner, design team, and contractor. Baystate Medical Center, working with SBA and Suffolk Construction Company, determined that a traditional design-bid-build process for a four-story fit-out of 96 inpatient beds and pharmacy was not viable based on budget and schedule. Using IPD, the team completed the south wing fit-out project one month ahead of schedule and over $1 million under budget. IPD is geared towards front-end decisions by the owner on critical, time-sensitive materials, resulting in early coordination of documents. This process is a good fit for securing early contracts for large infrastructure equipment and reducing changes in the design as the construction proceeds.
By creating a culture of Lean, you have benchmarks for decisions, processes for evaluating change, and opportunities to make improvements based on data. Each Lean Design Event builds on previous successes and becomes a part of your organization’s bigger picture.
Teresa Wilson, AIA, LEED AP, is the principal managing director at Steffian Bradley Architects in Boston.
