The Toyota system – often known as Lean – has been applied in many environments, including healthcare for some time now, with massive improvements in quality and efficiency. The underpinning aim of removing activities that don’t add value lies at the heart of healthcare, and the principles of Lean are the same. One team in Barnsley is finding out the benefits of Lean working and has already been able to achieve huge cost and time savings as a result.
The Barnsley community equipment service aims to help people towards independence and improve health and wellbeing by loaning equipment and daily living aids to people in Barnsley. It has a vast selection of equipment such as commodes, walking frames and slings that can be ordered by health professionals to assist a person’s health and social care. The service manages, cleans, maintains, delivers and repairs all equipment through one central team.
In June 2011 the team, which works with 40 different services including Barnsley Council and Barnsley PCT, moved to new premises at Grange Lane Industrial Estate in order to improve efficiency and work practices. Prior to this it was based at Kendray Hospital but struggled with space limitations and a number of outsourced contracts.
To address the need and to take advantage of new opportunities a business proposal was submitted. The proposal aimed to bring everything that was outsourced, such as the decontamination of equipment, back in-house, but to do this new premises would be required. A suitable unit was identified and work began to relocate the service and find new ways of working to improve service delivery.
Logistical problems of having various storage sites were addressed with a majority of all stock brought to this one central point. This reduced the amount of journeys needed to collect stock before any of the other essential jobs could be carried out such as taking care of repairs and deliveries. This has seen a big reduction in miles driven and fuel costs, as well as an improvement of the carbon emissions from work related journeys.
Until the service moved to the new site 7,500 journeys were made each year to inspect and test equipment. Now that all equipment is centrally located this can be done on site.
One of the changes that has had the biggest impact is the introduction of the service’s own decontamination unit. This work was previously outsourced which cost a lot of money and added time and created complications to the supply chain. Through close work with a specialist company an innovative structure was built within the unit which would house all decontamination work. When any piece of equipment is returned from use it must be cleaned thoroughly before it can be sent back out into the community. This specialist area enables the team to carry out the necessary decontamination process onsite allowing the equipment to be quickly available again for use. This has saved around 1,500 journeys a year that were connected to the outsourced process.
Another area of work that was outsourced was the maintenance of equipment. Now a special workshop provides all the essential kit that suppliers would need to repair equipment. Working in partnership with suppliers engineers now come on site to mend items instead of the team having to send equipment back to the suppliers. This partnership working has made it easier to keep track of repairs and to ensure work is done in the shortest time possible making the stock available again for reallocation. This has also pushed the equipment recycling rate up to 91% from 56% previously, having huge cost savings.
An intelligent computer system has been put to better use by the team to make it work in a way that meets their needs. The system is now used to keep track of around 100,000 items that are out in the community at any one time. The system lets staff see who has something, where it is, when it is due to be serviced and many more vital bits of information that enable the team to work effectively.
Staff have been a massive part in the improvements and together they have been able to apply a lean implementation programme to allow further improvements to everyday tasks, such as organising slings into coloured trays to quickly identify different types.
Since starting with the 5 S theory in January 2010 the team have rolled out a number of lean ways of working to help improve efficiency. This includes standardising equipment so having just one type of commode instead of three making space and simplifying the order process.
The 5S metholodgy
5S is the name of a workplace organisation methodology that uses a list of five Japanese words to organise a work space for efficiency and effectiveness: sort, straighten, shine / sweep, standardise and sustain.
Since then staff keep coming up with ideas to improve the delivery process, ordering systems and storage of equipment. The new culture shift took some getting used to, but now the team haven’t looked back and instead of having to make as conscious effort to work in a Lean way, it’s just part of their everyday work.
Lean working has helped the team surpass KPI criteria to get each piece of equipment delivered within seven days, recording a rate of 99.7% in August, above the 90% KPI criteria.
Operational manager Wayne Bendelow said, "There is still some work to be done particularly with the teams we work with to get them to help us work efficiently. But we are currently exploring ways of improving this through the implementation of an electronic order system."
He added, "The work we’ve done so far has helped reduce the number of steps in our supply chain and we are even looking to take this one step further by having satellite stores with key equipment in main areas such as Barnsley General Hospital. This means patients can take the necessary items home with them from hospital without having to wait for an order and delivery to be made once they are discharged."