15 Project 2: Decrease Queuing Bottle neck in the middle !!
16 Appointment leveling Decrease batching Takt time matches cycle time Increase flow of the processGoal: Not more than 1 patient waiting in front of the O.R.
17 Project 3: Pull system for OR porter In-room nurse calls for the porterbefore finishing the case.‘Just in time’
18 ResultDecreased waiting time in front of the O.R. from 62 min to 22 minAfter project 1-3, the whole process time = 3 hrs 10 min (-1Hr 26 min)
19 Compare pre- and post-lean Pre-LeanMeanPost-LeanTotal value added timemin92 minminTotal turn around timemin277 minmin192 min% value added12% - 71%33%19% - 75%48%FTQ of value stream79%89%No. of activity steps3524
22 Results Total process time ~ 3 Hrs (12 min reduction) Complication survey: No post-operative endophthalmitis reported
23 Satisfaction survey - Staff Opinion about this lean project (SQDCM)Pre-LeanPost-LeanBetter service quality to the patients (Q)3.153.44More convenience to the patients (Q)3.353.37More work-load for the staff (M)2.65*3.22Risk of post-op complication (S)3.15*I have to wait for the up-stream process (D)2.85*3.59Lean project reduces waste in my work (Q)2.703.74I feel more safety in routine work (S)3.00I feel more quality in my work (Q)3.10I feel myself worthwhile (M)2.903.33This project is worth for the change (C)
24 Continuing improvement ‘Match Takt time with cycle time’Interval of appointed time is tailored for individual surgeon