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Kaizen EventProcess improvement in action
Once upon a time a Birth Center and NICU had a dream.To resuscitate fragile patients with the best processes possible.The leadership team had a meeting: The family birth center leader, the NICU leader, and the respiratory care leader.
A Kaizen was suggested by one wise leader.“What is a Kaizen,” Asked the other two leaders?A Kaizen is a process of examining a work flow and making it streamline or lean from the clients point of view.
In its simplest form, Kaizen means that you improve something every day!
It is both a philosophy & a methodology
Kaizen Improvements are generally not intended to be radical, earth-shattering improvements.  Instead, they’re regular incremental improvements that eliminate waste, here, there, and everywhere, bit by bit. Kaizen Event
“The most important thing is to take the best care of our babies,” said the NICU leader. “The babies and their families are our customers. They must come first,” said the birth center leader.“Yes, lets have a kaizen,” said the respiratory care leader!
StandardTrainingCurrent State – understand (gemba)Identify wastes and opportunitiesPrioritizeFuture stateAction listImplement – executeSustainability - audits
Examining the current state, work flow, of a new born resuscitation
Principles of Lean ThinkingIdentifyValue from the customer’s perspectiveIdentify the Value Stream for the product or serviceRemove waste and design the value stream to improve FlowProduce based on customer PullContinuously improve the value stream towards PerfectionLean Thinking, Womack and Jones, 1996
Principle #2: What’s a Value Stream?Value Stream: All of the actions / activities, both value-added and non-value-added, that are accomplished to deliver completed customer value.  (ACTIVITIES, not people)Value StreamProcessProcessProcessCustomerRequestCustomerReceipt
Taking out wasted timeThe value stream from the customers perspective. The baby deserves a resuscitation process that flows quickly and smoothly. We examined the equipment placement, staff positioning, and role responsibilities. This was to take out any lag time for equipment being available and ready to use.Positions were analyzed for the best place for each  person, based on role, to stand.
Customer pullIn a resuscitation work process, the customer pull is a baby being born who has specific criteria related to the labor process.There is no waste in the pull arena because the resuscitation team is only called in specific circumstances.
Examiningevery detail!!
Efficient designs were thought through. Three different areas were evaluated. The birthing, the operating, and the neonatal rooms.All three areas had recommended changes.The changes were trialed for two weeks.Recommendations were reviewed.Changes evaluatedEquipment and work flow changes finalized.Roll out of changes organizedRoll out implemented
The most efficient setup designedRespiratory equipment readyBed ready
Nursing equipment readyExample: room ready for resuscitation

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Kaizen event

  • 2. Once upon a time a Birth Center and NICU had a dream.To resuscitate fragile patients with the best processes possible.The leadership team had a meeting: The family birth center leader, the NICU leader, and the respiratory care leader.
  • 3. A Kaizen was suggested by one wise leader.“What is a Kaizen,” Asked the other two leaders?A Kaizen is a process of examining a work flow and making it streamline or lean from the clients point of view.
  • 4. In its simplest form, Kaizen means that you improve something every day!
  • 5. It is both a philosophy & a methodology
  • 6. Kaizen Improvements are generally not intended to be radical, earth-shattering improvements. Instead, they’re regular incremental improvements that eliminate waste, here, there, and everywhere, bit by bit. Kaizen Event
  • 7. “The most important thing is to take the best care of our babies,” said the NICU leader. “The babies and their families are our customers. They must come first,” said the birth center leader.“Yes, lets have a kaizen,” said the respiratory care leader!
  • 8. StandardTrainingCurrent State – understand (gemba)Identify wastes and opportunitiesPrioritizeFuture stateAction listImplement – executeSustainability - audits
  • 9. Examining the current state, work flow, of a new born resuscitation
  • 10. Principles of Lean ThinkingIdentifyValue from the customer’s perspectiveIdentify the Value Stream for the product or serviceRemove waste and design the value stream to improve FlowProduce based on customer PullContinuously improve the value stream towards PerfectionLean Thinking, Womack and Jones, 1996
  • 11. Principle #2: What’s a Value Stream?Value Stream: All of the actions / activities, both value-added and non-value-added, that are accomplished to deliver completed customer value. (ACTIVITIES, not people)Value StreamProcessProcessProcessCustomerRequestCustomerReceipt
  • 12. Taking out wasted timeThe value stream from the customers perspective. The baby deserves a resuscitation process that flows quickly and smoothly. We examined the equipment placement, staff positioning, and role responsibilities. This was to take out any lag time for equipment being available and ready to use.Positions were analyzed for the best place for each person, based on role, to stand.
  • 13. Customer pullIn a resuscitation work process, the customer pull is a baby being born who has specific criteria related to the labor process.There is no waste in the pull arena because the resuscitation team is only called in specific circumstances.
  • 15. Efficient designs were thought through. Three different areas were evaluated. The birthing, the operating, and the neonatal rooms.All three areas had recommended changes.The changes were trialed for two weeks.Recommendations were reviewed.Changes evaluatedEquipment and work flow changes finalized.Roll out of changes organizedRoll out implemented
  • 16. The most efficient setup designedRespiratory equipment readyBed ready
  • 17. Nursing equipment readyExample: room ready for resuscitation
  • 18. Changes identifiedThe Doctor or Neonatal Nurse Practioner stands at the head of the bed. The head of the patient is placed in front of the Doctor or Practioner to intubate, if needed.A respiratory therapist (RT) or 2nd RN on the right of the head of the patient. This person helps manage the airway and assists with intubation.The RN is on the left of the baby and monitors the heart rate and effectiveness of airway management.
  • 19. OutcomesChanges evaluated and implementedFinal decisions made to change the process of equipment preparation, staff roles, and staff positioning.The streamline outcome is a smooth running resuscitation with wasted time taken out of the work flow. Everyone knows their function based on where they are standing.The patient is placed first and it shows.
  • 20. Kaizen The Kaizen standardize process is useful to standardize work flow process. The Kaizen takes out nonproductive wasted time.The Customer is placed first. Changes are made from the customer’s perspective.Wasted steps are removed.Overproduction is stopped by allowing demand from the customer to pull resources instead of just producing a product.Kaizen is applicable to every work process.