Lean Healthcare – Cleaning up the laundry processImproving Laundry process for OR materials
· Most hospitals in a large non-profit system had on-site laundry facilities, which were aging and in need of replacement. Instead of further investments in these individual hospital laundry facilities, system leaders saw an opportunity to gain efficiencies through centralizing laundry services in a large off-site industrial laundry facility (and eventually offering services to hospitals and clinics outside of their system). A total of $10,000,000 was invested in a state-of-the-art facility with no expense spared. From the initial launch of the laundry, shortages of operating room (OR) towels and scrubs were threatening to shut down the OR at the main hospital (the financial engine of most hospitals), and the offsite (laundry processing) and onsite (laundry distribution) managers were not on speaking terms due to animosity and finger pointing resulting from this poor system performance.
challenge
- Eliminate OR scrub and OR Towel outages at the main hospital.
- Re-establish and improve the operational and working relationships of the onsite and offsite laundry managers.
- Dramatically improve reliability of laundry deliveries
- Decrease outage calls to the flagship hospital
- Decrease workload of staff associated with the flow of laundry
- Improve utilization of floor space at both facilities (onsite and offsite)
- Decrease system risk due to offsite laundry (if weather or other event cut off hospital from offsite laundry)
solution
· Given contentious situation, conducted extensive Nemawashi and Genchi Genbutsu to thoroughly understand the process, breakdowns, opportunities, and interpersonal challenges
· Conducted a Value Stream Mapping event, which created 150 team-derived action items. Given particularly fractured process, proposed a conceptual future state vision of “pull” and “kanban” to gauge the team’s thoughts, which were extremely positive and thoroughly adopted (essentially a high level “kata” vision to challenge them) (see Figure 2)
· Utilized a “Paper Kaizen” approach to engage staff (see Figure 3)
· Due to critical and time-sensitive nature of the project, expedited project and facilitation of action plan from the norm of approximately 1 year to approximately 2 months
· Changed elevators from 2 cart per ride elevator to a service elevator that could carry 6 or 8 carts at a time (dramatically reducing trips)
· Restocking to a PAR rather than a fixed daily order. Onsite and offsite laundry operating based on visual Kanban and PAR’s defined by managers and staff
· Predictable delivery schedule for both clean and dirty (return) flow
results
· Enabled a close and friendly working relationship between onsite and offsite laundry managers…who became friends and communicated continuously throughout the day!
· Established supermarket based pull system at hospitals and laundry facility (see Figure 4)
· Decreased outage calls at flagship hospital from 45 to less than 4 calls/day
· Solved pillow return problem, thus avoiding original plan of moving to disposable pillows
· Decreased system risk posed by offsite laundry by establishing safety-stock and rotation system at onsite laundry distribution area
· Decreased Average Total Trip Time from 78 minutes to 66 minutes (15.4% reduction)
· Time per cart decreased from 144 seconds/cart to 120 seconds/cart (16.6% reduction)
· 98% of 150 Action Items completed by the end of the main project
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