The Projects:

23Lean improvement projects have been delivered in the last 3 years.

Area / Location / Event Type / Month / Duration
Orthopaedic theatres / Wishaw / Kaizen / July 2008 / 3 months
General Surgery theatres / Monklands / Kaizen / October 2008 / 3 months
Orthopaedics/
Ophthalmology theatres / Hairmyres / Kaizen / December 2008 / 3 months
Pharmacy / Wishaw / Kaizen / December 2008 / 3 months
Pharmacy / Monklands / Kaizen / April 2009 / 3 months
Emergency medical flow through A&E and ERU / Monklands / Kaizen / September 2009 / 3 months
Bed management and discharge / Monklands / Kaizen / December 2009 / 3 months
Care of the Elderly and stroke / Hairmyres / Kaizen / March 2010 / 3 months
Medical wards / Hairmyres / Kaizen / May 2010 / 3 months
Emergency medical flow through A&E and AMRU / Hairmyres / Kaizen / June 2010 / 3 months
Vascular surgical flow and rehabilitation / Hairmyres / Kaizen / September 2010 / 3 months
Acute adult mental health / Wishaw / Kaizen / December 2009 / 3 months
Acute adult mental health / Monklands/ Hairmyres / Kaizen / March 2010 / 3 months
Mental Health referral management / NHSL / Kaizen / May 2010 / 3 months
Crisis standards / NHSL / Workshop / January 2010 / 2 months
Haematology / NHSL / Workout / July 2010 / 2 months
Cardiology / NHSL / Workout / September 2010 / Ongoing
Older People’s Services / NHSL/NLC / Kaizen / October 2010 / Ongoing
Admin and Clerical / NHSL / Pre-work underway / November 2010 / Ongoing
Endoscopy / NHSL / Workout / December 2010 / Ongoing
Gastroenterology / NHSL / Workout / February 2010 / Ongoing
Dermatology / NHSL / Workout / February 2010 / Ongoing
Procurement/Finance / NHSL / Workout / February 2011 / Ongoing

Successful Outcomes - Examples

Theatres:

  • Increase in volume in Orthopaedic Surgery
  • More major joints per session
  • Increase Same Day Admission (Bed-days saved)
  • Reduction in same day cancellations
  • Improved start time
  • Increase in Cataract Surgery volume
  • Staff Involvement
  • Patient Safety
  • Improved patient experience

Pharmacy:

  • Increase in discharge prescription dispensing within one hour
  • Single flow dispensing
  • Prescription tracking
  • Patient safety – zero missed drug doses
  • Communication
  • Staff morale increase

Medical Flow:

  • Reduced median length of stay
  • Improved medicines reconciliation
  • More accurate drug history
  • Stroke standards improved/exceeded
  • Improved bed management and patient flow
  • Multiple assessments/duplicate paperwork removed
  • Improved minors flow
  • Admission avoidance for significant number of elderly patients
  • Releasing nursing time to care
  • Better tracking of patients

Surgical flow:

  • Earlier focus on discharge planning
  • Improved patient experience
  • Reduced length of stay
  • Better communication between nursing and AHP staff
  • Improved patient/carer information
  • Beds utilized better – right patient in right ward
  • Clear recovery pathway for vascular patients
  • Rehabilitation pathway for amputees
  • Reductions in length of stay for vascular patients
  • Releasing nursing time to care
  • Reduced stationery costs

Mental Health:

  • Pan-Lanarkshire crisis standards
  • Improved therapeutic interventions
  • Integrated care pathway development
  • Observation levels – increased compliance with MILLAN principles
  • Positive patient experience and involvement in care planning
  • Reduced use of bank and agency staff
  • Reduced length of stay
  • Better communications between acute and community psychiatric nurses
  • Improved measurement system

Unsuccessful projects: Although some projects had a bigger impact than others, none could be deemed as unsuccessful as all delivered improvements to quality of care, patient safety and experience.