Applications of lean thinking: a briefing document

This report has been put together by the Health and Care Infrastructure Research and Innovation Centre (HaCIRIC) at the University of Salford for the Department of Health. The need for the report grew out of two main simple questions, o Is Lean applicable in sectors other than manufacturing? o Can the service delivery sector learn from the success of lean in manufacturing and realise the benefits of its implementation?The aim of the report is to list together examples of lean thinking as it is evidenced in the public and private service sector. Following a review of various sources a catalogue of evidence is put together in an organised manner which demonstrates that Lean principles and techniques, when applied rigorously and throughout an entire organization/unit, they can have a positive impact on productivity, cost, quality, and timely delivery of services

A lean way of design and production for healthcare construction projects

As a consequence of the lack of solid conceptual foundation, the project management concepts and techniques usually applied within the construction sector are fragmented and have proved to be incapable of solving the complex problems of design management. As a result, healthcare providers have become frustrated with the outcomes such as cost and schedule overruns, accidents, less than expected quality and inadequate functionality. However, an investigation of successful healthcare projects reveals that new approaches have been developed to tackle such problems. This study uses recent data based on six construction projects. The idea is demonstrate how successful projects are dealing with the integration between design, production, and operations, through an appropriate approach to the management of production systems. The paper aims to assist the different parties of the AEC industry to better understand how practices applied into design phase could support the efficiency in the management of production systems

Benefits realisation for healthcare

Following the emergent importance of benefits realisation applied to healthcare infrastructure and service development programs, HaCIRIC has undertaken a research initiative targeting the development of a robust and comprehensive Benefits Realisation (BeReal©) process. The resulting model is focusing on how benefits should be elicited at the initial strategic stages, and how benefits should be deployed, managed and traced along the lifecycle of a programme so their realisation contributes to successful health outcomes. Subsequently BeReal© aspires to be an appropriate method to drive and control the programme plan; providing tools and techniques for defining specific benefits. It also allows the measurement and evaluation of the extent to which those benefits are delivered. We have set ourselves the objective of identifying current best practices and demonstrate how to improve benefits realisation in healthcare infrastructure provision. The HaCIRIC team in active collaboration with leading industry partners have undertaken various case and comparator studies not only to define a business critical process but to set out an ideology which places benefits realisation at the heart of securing wholly integrated (collective) change. We believe that to deliver consistent high quality infrastructure and services within an ever changing investment model requires a different level of thinking and understanding towards benefits realisation. The challenge of answering community needs through intelligent investment in infrastructure is complex and demands a deeper and inclusive awareness and appreciation of how to deliver benefits and effectively allocate resources. The BeReal© initiative seeks to contribute methodologically and intends to help spending money intelligently, working with programme and project related stakeholders, securing that the best possible benefits are obtained for the overall healthcare communities. This report highlights selected performed initiatives and summarises BeReal© process’s major characteristics, covering far more than the follow-up of a competitive tendering process and of the development of a traditional business case. BeReal© copes with a detailed definition of changing activities, breakdown of (needs into) benefits that drive the investment, supports decision-making, proposes the development of controlling initiatives and suggests major awareness to the implementation of corrective actions. We seek to continue innovating, stimulate learning, contributing to an increase of health and care performance that properly answers to community needs and intelligently invests public and private resources

Application of simulation and modelling in managing unplanned healthcare demand

Patients who attend Accident and Emergency (A & E) departments with problems that could be dealt with by their general practitioners (GPs) use time and resources of the department that could be otherwise used for patients with more appropriate needs. Hospital managers throughout the world are facing increasing pressure to introduce measures and initiatives to significantly ease the problem of such inappropriate attendances at A&E departments. This study looks at an initiative in which primary care clinicians are used to help deflect patients with non-urgent needs away from A&E. Simulation and modelling was used to assess the impact that this initiative would have on A&E workflow. The results suggest that the deflection of patients attending A&E with non-urgent needs may reduce the time spent in A&E by all patients attending A&E

Modelling and simulating unplanned and urgent healthcare: the contribution of scenarios of future healthcare systems.

The current financial challenges being faced by the UK economy have meant that the NHS will have to make £20 billion of savings between 2010 and 2014 requiring it to be innovative about how it delivers healthcare. This paper presents the methodology of a research project that is simulating the whole healthcare system with the aim of reducing waste within urgent unscheduled care streams whilst understanding the impact of such changes on the whole system. The research is aimed at care commissioners who could use such simulation in their decision-making practice, and the paper presents the findings from early stakeholder discussions about the scope and focus of the research and the relevance of stakeholder consultation and scenarios in the development of a valid decision-support tool that is fit for purpose