As hospitals and healthcare systems struggle to balance rising cost with reimbursement, capital investments such as building renovation and expansion must bring tangible savings through enhanced environmental and operational efficiency. Requests for expertise in Lean Design Services in architectural proposals or RFP’s are becoming very common.

It is true that new construction offers a unique opportunity to correct years of process workarounds and suboptimal space utilization.  Lean healthcare principles can be used effectively to guide the development of optimal future-state processes which can then be applied to create a supportive architectural design.  The opportunity for improved patient outcomes while reducing or eliminating waste can be unprecedented. Unfortunately, the benefits of Lean cannot be realized through Lean healthcare design alone.

Important considerations before employing Lean Healthcare Design:

  • New facility design can support Lean processes, but it is essential that the organization’s leadership team be enthusiastically committed to beginning or continuing its lean journey toward waste-free work.
  • Lean does not end with building completion. Lean healthcare processes must continually evolve after building occupancy and the design response must offer the flexibility necessary to accommodate change over time.
  • The concept of “standard work” must be embraced throughout the organization at every level as part of its culture in order to achieve the full benefit of the Lean Design. This can be more difficult than it sounds. Department managers must agree to standardize work processes across departments. For example, unit secretary workstations and work processes are identical regardless of location within a facility.
  • The comprehensive use of visual management tools and standard placement of supplies and equipment are necessary to promote and sustain Lean processes. Communication boards, visual kanbans, and designated parking spaces for mobile medical equipment promote seamless transitions between caregivers prevent staff from searching for needed items.
  • Adequate staff preparation and Lean training is vital to patient and staff satisfaction as well as waste reduction. The staff must embrace the Lean processes that actually drove the building design. This cost is often underestimated.

If “going Lean” were easy, hospitals would no longer need waiting rooms. Nurses would not hoard supplies in the pockets of their uniforms and patients would never get hospital acquired infections. When a Lean healthcare organization can deliver healthcare in a supportive Lean environment, the successes achieved in the manufacturing world to eliminate waste and defects may actually be possible.

This week’s blog was written by Teresa Carpenter. Teresa is the Director of Lean Clinical Design with HPP and brings a unique perspective to lean healthcare as a registered nurse with extensive architectural design and facilities planning experience. Teresa began her career in healthcare working through the ranks from Admitting Clerk to Patient Care Director of various critical care units, medical-surgical units, and support departments such as Respiratory Therapy and Cardiac Rehabilitation in several South Carolina facilities. With over 12 years experience in theacute care environment, Teresa moved to Nashville where she spent almost a decade as Clinical Operations Coordinator for an internationally recognized leader in healthcare architectural design. Teresa facilitated process engineering services as a component of the design process for hospital renovations, as well as large-scale green field and replacement facility projects. Teresa assists hospitals and healthcare systems in all aspects of applying Lean to the master plan, design, and operational aspects of a facility design or clinical expansion. Teresa holds a bachelor’s degree in Business Administration from the College of Charleston, and a degree in nursing from Trident College in Charleston, South Carolina.

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