0 Understanding Lean Using a Kaizen Event to

0 Understanding Lean: Using a Kaizen Event to Improve Multi-Department Processes ming Hospitals – Improving Care

45 Years of Delivering Results Health. Tech. S 3 is a 45 year old, award-winning healthcare consulting and strategic hospital services firm based in Brentwood, Tennessee with clients across the United States. We are dedicated to the goal of improving performance, achieving compliance, reducing costs, and ultimately improving patient care. Leveraging consultants with deep healthcare industry experience, Health. Tech. S 3 provides actionable insights and guidance that supports informed decision making and drives efficiency in operational performance. Our consultants are former hospital leaders and executives. Health. Tech. S 3 has the right mix of experienced professionals that service hospital clients across the nation. Health. Tech. S 3 offers flexible and affordable services, consulting, and technology as we focus on delivering solutions that can be implemented and provide a positive, measurable impact. 1 1

STRATEGY – SOLUTIONS – SUPPORT GOVERNANCE & STRATEGY • Affiliation Consulting FINANCE • Performance Optimization / Margin Improvement • Executive & Management Leadership Development • Revenue Cycle & Business Office Operations • Strategic Planning & Market share Analysis • Productivity & Staffing Consulting - Optimum Productivity Toolkit • Community Health Needs Assessment • Compliance Consulting Services 2 CLINICAL CARE & OPERATIONS • Continuous Survey Readiness • Quality Assurance Performance Improvement • Lean Culture • Customer Experience • Clinical Resource Management • Care Coordination – Primary Care Practice • Physician Practice & Clinic Assessment • Long Term Care Consulting • Swing Bed Consulting • Perioperative Services Consulting RECRUITMENT • Executive Recruitment • Manager and Clinical Positions • Physician / Provider Recruitment • Information Technology Professionals • Interim Placement

Your Swing Bed Questions Answered Date: October 4, 2019 Time: 1: 00 pm CST Presenter: Carolyn St. Charles, RN, BSN, MBA, Regional Chief Clinical Officer Health. Tech. S 3 https: //bit. ly/2 l 3 py. AO CMS Changes, Co. Ps and Discharge Planning Requirements – What do They Mean for Your Organization? Date: October 18, 2019 Time: 12 pm CST Presenter: Carolyn St. Charles, RN, BSN, MBA, Regional Chief Clinical Officer Understanding Lean and Using a Kaizen Event to Improve Multi. Department Processes Date: November 21, 2019 Time: 12 pm CST Presenters: Faith M Jones, MSN, RN, NEA-BC, Director of Care Coordination and Lean Consulting, Health. Tech. S 3; Tracy Clarno, PMP, CPHQ, Think Lean Consulting https: //bit. ly/2 nggbi 6 https: //bit. ly/2 pg. VALy Planning for a Successful Hospital Survey Date: December 6, 2019 Time: 12 pm CST Presenter: Carolyn St. Charles, RN, BSN, MBA, Regional Chief Clinical Officer Chronic Care Management Coding: How to Deal with Combo Codes and The Impact on Revenue Date: October 24, 2019 Time: 12: 00 pm CST Presenters: Faith M Jones, MSN, RN, NEA-BC, Director of Care Coordination and Lean Consulting, Health. Tech. S 3; Julianna Seaman, CCS-P, Coding and 8 Critical Strategies for Interim Executives Date: December 11, 2019 Time: 12 pm CST Presenter: Mike Lieb, Vice President – Interim Services, Health. Tech. S 3 https: //bit. ly/2 nb. Ugs 9 Best Practices from Nurse Leaders Date: November 1, 2019 Time: 12 pm CST Presenter: Carolyn St. Charles, RN, BSN, MBA, Regional Chief Clinical Officer Team-Based Care and Achieving Optimal Performance Date: December 19, 2019 Time: 12 pm CST Presenters: Faith M Jones, MSN, RN, NEA-BC, Director of Care Coordination and Lean Consulting, Health. Tech. S 3; Kara Beech, Beech Creative Group https: //bit. ly/2 l 7 ZFz. T CDI Director, e. Catalyst Healthcare Solutions https: //bit. ly/2 l. LCh. Zd https: //bit. ly/2 niij. G 7 Diversity and Inclusion at the Hospital Senior Leadership Team Level Date: November 15, 2019 Time: 12 pm CST Presenter: Peter Goodspeed, MBA, VP of Executive Search, Health. Tech. S 3 https: //bit. ly/2 ngd. Wvc https: //bit. ly/2 m. MPe. Cb Go To www. Health. Tech. S 3. com to register ALL WEBINARS ARE RECORDED

Instructions for Today’s Webinar 4 You may type a question in the text box if you have a question during the presentation We will try to cover all of your questions – but if we don’t get to them during the webinar we will follow-up with you by e-mail You may also send questions after the webinar to our team (contact information is included at the end of the presentation) The webinar will be recorded and the recording will be available on the Health. Tech. S 3 web site: www. healthtechs 3. com Health. Tech. S 3 hopes that the information contained herein will be informative and helpful on industry topics. However, please note that this information is not intended to be definitive. Health. Tech. S 3 and its affiliates expressly disclaim any and all liability, whatsoever, for any such information and for any use made thereof. Health. Tech. S 3 does not and shall not have any authority to develop substantive billing or coding policies for any hospital, clinic or their respective personnel, and any such final responsibility remains exclusively with the hospital, clinic or their respective personnel. Health. Tech. S 3 recommends that hospitals, clinics, their respective personnel, and all other third party recipients of this information consult original source materials and qualified healthcare regulatory counsel for specific guidance in healthcare reimbursement and regulatory matters.

5 Faith M Jones, MSN, RN, NEA-BC Director of Care Coordination and Lean Consulting Faith Jones began her healthcareer in the US Navy over 30 years ago. She has worked in a variety of roles in clinical practice, education, management, administration, consulting, and healthcare compliance. Her knowledge and experience spans various settings including ambulance, clinics, hospitals, home care, and long term care. In her leadership roles she has been responsible for operational leadership for all clinical functions including multiple nursing specialties, pharmacy, laboratory, imaging, nutrition, therapies, as well as administrative functions related to quality management, case management, medical staff credentialing, staff education, and corporate compliance. She currently implements care coordination programs focusing on the Medicare population and teaches care coordination concepts nationally. She also holds a Green Belt in Healthcare and is a Certified Lean Instructor. Healthcare Focus 45 Year Company History Experienced Consultants Technology Partnerships

Objectives Upon completion of the webinar, the participant will understand: • The basic concepts of Lean • The How and Why of using Kaizen Events 6

Brief History of Lean • W. Edwards Deming – Improve design and product quality • Taiichi Ohno – Toyota Production Systems • Jim Womack – Lean & LEI (Lean Enterprise Institute) • Bowen & Spear – Decoding the DNA of the Toyota Production System • C. Jimmerson & D. Sobek – Lean for Healthcare 7

Lean Philosophy …creating value by understanding what customers value …the continuous pursuit of the perfect process through waste elimination. 8

9 Key Components Concepts • • IDEAL Four Rules in Use Seven “Mudas” Power of Observation Tools • Value Stream Mapping • A 3 Problem Solving

IDEAL • Exactly what the customer needs/wants, Exactly • Defect free • One-by-one, customized to each patient • On demand, exactly as requested • No waste • Immediate response to problems or changes • Physically, professionally, emotionally safe 10

Rule 1: Rule 112: 4 Rules in Use Direct Specific: • • Content Timing Sequence Outcome : 3 e l s u y a R a P w th Rule 4: Immediate Response to a problem

Muda 12 • Confusion* • Motion • Waiting • Processing • Inventory • Defects • Over-production *Jimmerson, C. (2010) Value stream mapping for healthcare made easy. P 4.

Power of Observation Really understand how work currently happens is essential before trying to fix it! 13

Lean: Simple Formula 14 Liberate the people who do the work to use a proven method to look at what they do with “new eyes” to identify elements of the work that permit: • Errors and delay in care/service • Waste of resources • Frustration in the workplace

Lean: Simple Outcomes • Happier workers • Happier customers • Increased capacity for work • Lower operating cost 15

The Lean Journey Cultivate a Supportive Environment Provide the right tools Grow the front lines 16

17 Tracy Clarno, PMP, CPHQ Owner of Think Lean Consulting. Tracy has been a certified Lean Instructor for Healthcare since 2014 and has excelled in the quality improvement arena. Through her consulting services, she assists organizations by facilitating Kaizen events and 5 S events as well as provides professional development to individuals through Lean Process Improvement Coaching.

Kaizen Tracy Clarno, PMP, CPHQ Certified Lean Instructor Certified Lean Greenbelt

Philosophy of Continuous Improvement

• A kaizen event is one arrow in the lean “quiver. ” Or one tool in the lean “toolbox. ”

Before a Kaizen Event This Photo by Unknown Author is licensed under CC BY-ND

Selecting the Scope • Waste • Value Stream Map • Metrics • Key performance Indicators • Sense

• 50% staff who perform the work • Limit the number of managers • Work touches the processes • Internal supplies and customers • Subject matter experts • Objective viewpoint Selecting the Team

Preparing the Facility • Involve Senior Management • Define the physical boundaries/location of event • Communication with all staff • Alleviate fears • Outline the event Possible Example Day Event 1 Train, data gathering, observation and analysis 2 root cause analysis 3 define countermeasures and

During a Kaizen Event

6 phases Start Up Map Analyze Design Test Action

Start Up

Map

Analyze

Design

Test

Action

After a Kaizen Event

Observe Sustain the change Measure Monitor Present

5 S Kaizen Event

Sort

Set in Order

Shine

Standardize

Sustain

Summary *Kaizen Events *5 S Events *Lean Process Improvement Coaching Tracy Clarno, PMP, CPHQ Certified Lean Instructor Certified Lean Greenbelt

If you would like more information on Lean, please feel free to contact me. 43 This Photo by Unknown Author is licensed under CC BY-SA-NC Dallas Office Brentwood Office Our Phone Email 2745 North Dallas Parkway, Suite 100, Plano, TX 75093 5110 Maryland Way, Suite 200 Brentwood, TN 37027 Main Office: 615. 309. 6053 Executive Placement: 972. 265. 4549 Faith Jones Faith. Jones@healthtechs 3. com 307 -272 -2207