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Design Intervention: How a Lean 3P Event is a Catalyst for Change

By Kelly Christiansen

Lean 3P: A Quick Overview

Lean 3P (aka Production, Preparation and Process) is an event-driven process for developing a new product concurrently with the operation that will produce it. 3P is a game-changer that results in lower ongoing costs. The process: 

  • Guides teams who have multiple ideas to whittle them down to one that can be implemented.
  • Is known as a “3P event” that occurs anywhere from a couple of hours to a couple of days.
  • Includes trial and error to test distinctive designs.
  • Eliminates “waste” through the process.
    • Waste is anything that does not provide value to the end user—things like waiting, duplication of tasks, error correction, unnecessary travel, etc. Yes, I wish I had gone through a 3P event for all the times in my life I have moved.
  • Focuses on improving the process and the quality.
  • Examines the organization's goals and how to bring them to life.
  • Aims to solve problems so the enterprise can prosper.
  • Assesses each major value stream to make sure each step is valuable, capable, available, adequate, flexible, and that all the steps are linked by flow, pull, and leveling.

The skinny on the tools

Using multiple lean tools such as Gemba journaling, spaghetti mapping and rapid prototyping in a short amount of time, we can quickly understand the goals of an organization and the ideal patient flows and staff processes.

  • Gemba Journaling: “Gemba” is Japanese term meaning "the real place." It refers to the place where value is created. Origin cred: Gemba has roots in the manufacturing industry process at Toyota where the “place” was literally the factory floor and Gemba walks were conducted with each employee along the assembly line. This concept of continuous improvement is designed for enhancing processes and reducing waste. So, in the healthcare design industry, when we have staff detail their daily journeys in a Gemba journal, we understand how even the smallest improvements will create greater value over time.
  • Spaghetti mapping: Creating a spaghetti diagram is the visual creation of actual flow. It tracks distances and routes people travel throughout a space/facility. It ends up looking like spaghetti. *stomach rumbles*
  • Rapid Prototyping: By constructing a prototype of a space like an exam room (out of physical materials or in virtual reality), this tool provides a great way to test ideas and integrate feedback earlier into processes to ensure better ROI for long and short term.

These tools guide our team to provide design solutions that can help contribute to the best efficacy, the least number of errors, the ideal patient and staff experience and the most operationally efficient processes to ensure standardization and drive quality. A great example of this is when Monroe Clinic, an independent 58-bed community hospital and integrated delivery system in southwestern Wisconsin, partnered with Kahler Slater and determined that their hospital replacement project would serve as catalyst to transform their entire organization.

Monroe Clinic: A 3P Case Study with Powerful Results

Leadership took a close look at how care and services were being delivered, both on their current campus and at other organizations. Employee teams guided development of the project and discovered new operational approaches and best practices that could be implemented in their new hospital design. 

The four-story replacement hospital expansion includes a new campus entry; 57 acute and critical care beds; expanded emergency, catheterization, imaging and surgical services; a cardiac clinic and rehabilitation services, horizontally integrating with Monroe’s existing clinic on all levels.

Kahler Slater facilitated 3P Lean Workshops for Monroe Clinic with a priority on process improvements that impact space to incorporate new concepts early in design.  Two key projects that had significant impact on design were the re-design of the surgery patient experience and registration process. This employment of systems thinking is exactly what organizations need to do in order to be successful. And successful Monroe Clinic was! Redesigning the patient surgery flow improved on-time surgery starts, reduced significant arrival complexity, decreased travel distance for staff (from 16 discreet process steps across three floors in their older facility, to six steps on one floor in the new hospital), and prompted the redesign of the pre-admission testing and registration process. In other areas of the new hospital as well as in our current ambulatory work with Monroe Clinic, Kahler Slater is also collaborating with a Lean consultant to discover and implement new ways of delivering care. 

Looking at the numbers, Monroe Clinic’s new campus has achieved powerful results: 

  • 11.4% increase in revenue per discharge
  • 96th percentile inpatient satisfaction
  • 92nd percentile ambulatory services satisfaction 

Perhaps your organization could use a game-changer Lean 3P workshop to improve process and bolster your bottom line.  If you’re intrigued to learn more about this project or other aspects of our Lean programs, then contact Dave Sheedy: dsheedy@kahlerslater.com

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