Results & ROI
- Meeting lengths halved to 30 minutes – this has freed up staff to engage with patients and created an extra 2.5hrs per person per week (for attendees)
- Staggered meeting start times – multi-disciplinary teams from outside inpatient care can now attend both ward meetings (without requiring 2 staff to attend)
- Structured information cascade - gives a structure and expectation to enable the dissemination of timely information (accessible for all grades).
Lancashire Care NHS Foundation Trust provides health and wellbeing services for a population of around 1.4million people. The Trust covers the whole of the county and employs around 7,000 staff across more than 400 sites. The Trust commissioned Ad Esse to run a pilot Lean project, with the aim of testing the feasibility of developing an organisation-wide Lean programme.
With more emphasis on community-based care within mental health, maintaining focus on the demanding inpatient environment is vitally important to prevent repeat admission and facilitating timely discharge. Consequently, finite resources available to ward managers are under increased scrutiny. Effective time spent with patients and robust communication between ward and community teams are seen as key elements for successful mental health care. As a result, the acute care strand of the pilot looked at:
- Adult Inpatient Services: the inpatient environment and interface between inpatients and community based teams
- Key Improvement aim: increase staff time with patients by challenging and removing waste.
The first step was to conduct a Lean diagnostic and acertain the current position of the wards being reviewed. Part of the brief was to utilise Lancashire Care staff on the project and train them to become internal Lean Champions. Over a number of weeks, 25 ward staff were engaged (spread across 3 wards and a Mental Health Unit). To enable staff-led improvement, a series of workshops were run with staff from all levels and professions.
As a result of the workshops, a number of themes emerged and wastes were identified with ideas on how to eradicate them. The participative approach was key to making changes, as staff had an opportunity to make a difference to their working areas and practices (creating greater ownership of the improvements).
Alongside the ROI headlines, there has been increases in shared ownership, as the meeting structure is such that any member can facilitate the meeting in a standard way. There is also ownership of the information, as it is now being updated by multiple teams. 5 areas have been de-cluttered and organised in a structured way. Using internal Lean practitioners, who can take the time to absorb Lean principles and communicate them to front line staff, was critical in achieving and sustaining change.