Metrics-Based Process Mapping

Metrics-Based Process Mapping SHS Webinar ? February 17, 2009

Metrics-Based Process Mapping (MBPM)

Society for Health Systems Webinar February 17, 2009

Company

LOGO

Learning Objectives

The key time and quality metrics for designing Lean processes.

The difference between a value stream map and metrics-based process map.

The step-by-step approach for creating current and future state metrics-based process maps.

How to use the metrics-based process map as a standard work and process monitoring tool.

? 2009 Karen Martin & Associates

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? 2009 Karen Martin & Associatees. All Rights Reserved.

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Metrics-Based Process Mapping SHS Webinar ? February 17, 2009

Key Lean Metrics: Time

Process time (PT)

} The time it takes to actually perform the work, if one is able to work on it uninterrupted

} Includes task-specific doing, talking, and thinking } aka "touch time," work time, cycle time

Lead time (LT)

} The elapsed time from the time work is made available until it's completed and passed on to the next person or department in the chain

} aka throughput time, turnaround time, elapsed time

? 2009 Karen Martin & Associates

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Typical Current State Findings

Islands of value-adding activities All other time is "waste."

Rework

First Step

? 2009 Karen Martin & Associates

Adding Value

Lead Time

? 2009 Karen Martin & Associatees. All Rights Reserved.

Last Step

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Metrics-Based Process Mapping SHS Webinar ? February 17, 2009

Summary Metrics: Time

% Activity

} The percentage of time work is being done to the patient/item/data passing through the process/system

} (PT ? LT) ? 100

} 100 ? % Activity = Idle time of the "product" passing through the process/system

} Goal ? ID barriers to flow

? 2009 Karen Martin & Associates

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Key Lean Metric: Quality

%Complete and Accurate (%C&A)

} % time downstream customer can perform task without having to "CAC" the incoming work:

Correct information or material that was supplied Add information that should have been supplied Clarify information that should or could have been

clear

} This output metric is measured by the immediate downstream customer and all subsequent downstream customers.

? 2009 Karen Martin & Associates

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? 2009 Karen Martin & Associatees. All Rights Reserved.

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Metrics-Based Process Mapping SHS Webinar ? February 17, 2009

Summary Metrics: Quality

Rolled First Pass Yield (RFPY) =

} %C&A ? %C&A ? %C&A ? ...

} The percentage of occurrences where the information/data/people being processed pass through the entire process with no rework required

} Example: (0.95 x 0.60 x 0.85 x 0.75) x 100 = 36.3% RFPY

} Hint: the RFPY will always be lower than the lowest %C&A for an individual step.

? 2009 Karen Martin & Associates

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30,000 ft View

(Strategic)

The Work We Do: Degrees of Granularity

Value Value Stream

Stream

Map

Process Process Process

In the Weeds (Tactical)

Step

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Step

Step

Metrics-Based Process Map

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? 2009 Karen Martin & Associatees. All Rights Reserved.

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Metrics-Based Process Mapping SHS Webinar ? February 17, 2009

Hospital

4

Pre-register Patient

Lead Time = 24 days

5 3

Cycle Time = 30 mins. Lead Time = 990 mins. % C&A = 100 %

Current State Value Stream Map Outpatient Imaging Services

Demand = 15 per day

Lead Time = 990 mins.

CT Scans

Schedule Appointment

62

Cycle Time = 11 mins. Lead Time = 12 mins. % C&A = 98 %

Lead Time = 12 mins.

Referring Physician

1

Customer Demand: 15patients perDay (Takt Time1920seconds)

8 hours per day

% C&A = 65 %

CT=Cycle Time LT=Lead Time %C&A=% Complete & Accurate

Symposium

E Pay

Excel

ADS

Meditech

Internet

Waiting Room

Fax Order Solutions

PACS

Management

System

Auto Fax 50% Us Mail 25% MD Mailbox 25%

Rework Loop via Fax 25% of the time

5 mins.

Check-in Patient (Admitting)

Check-in Patient (Imaging)

Prep Patient (Tech)

Complete Exam (Tech)

Transmit Images (Tech)

Read/Dictate Exam

(Radiologist)

Transcribe Report (MDI)

Review Draft/Sign (Radiologist)

Print Reports (Imaging)

Send Reports (Imaging)

5

5 5 mins.

3

6 45 mins. 2

7 30 mins.

2

8 5 mins.

2

9 248 mins. 2 10 365 mins. 6 11 960 mins. 2

12 110 mins. 2

13 120 mins. 6

14

Cycle Time = 2 mins. % C&A = 90 %

Cycle Time = 1 mins. % C&A = 98 %

Cycle Time = 10 mins. % C&A = 100 %

Cycle Time = 15 mins. % C&A = 90 %

Cycle Time = 3 mins. % C&A = 100 %

Cycle Time = 15 mins. % C&A = 95 %

Cycle Time = 5 mins. % C&A = 75 %

Cycle Time = 1 mins. % C&A = 95 %

Cycle Time = 1 mins. % C&A = 99 %

Cycle Time = 3 mins. % C&A = 90 %

0.0833 hrs.

2 mins.

0.0833 hrs.

1 mins.

0.75 hrs.

10 mins.

0.5 hrs.

15 mins.

0.0833 hrs.

3 mins.

4.13 hrs.

15 mins.

6.08 hrs.

5 mins.

16 hrs.

1 mins.

1.83 hrs.

1 mins.

2 hrs.

3 mins.

LT = 32.5 hrs. CT = 56 mins. CT/LT Ratio = 2.87%

Rolled First Pass yield = 29%

Future State Value Stream Map Outpatient Imaging Services

Hospital

3

Work Balance

Lead Time = 15 days

Standard Work

Schedule appt Pre-register

6 2

Cycle Time = 11 mins. Lead Time = 45 mins. % C&A = 98 %

Co-locate

Lead Time = 45 mins.

Risk Reduction

(Joint Commision)

Referring

1 Physician

% C&A = 85 %

Customer Demand: 15 patients perDay (Takt Time1920 seconds)

8 hours per day

CT=Cycle Time LT=Lead Time %C&A=% Complete & Accurate

Symposium

E Pay

Excel

Meditech

Internet

Waiting Room Management

System

Fax Order Solutions

Remove Check in and Reduce System Access

Pull System (Supplies Kanban)

Standard Work

Set-up Reduction

Work Balancing

Value Stream Alignment

Visual Workplace

Continuous Flow

Check-in Patient (Imaging)

Prep Patient (Tech)

Complete Exam (Tech)

Transmit Images (Tech)

Read/Dictate Exam

(Radiologist)

5 mins.

3

4 35 mins.

2

5 20 mins.

2

6 5 mins.

2

7 120 mins.

2

8

Cycle Time = 1 mins. % C&A = 98 %

Cycle Time = 10 mins. % C&A = 100 %

Cycle Time = 10 mins. % C&A = 90 %

Cycle Time = 2 mins. % C&A = 100 %

Cycle Time = 15 mins. % C&A = 95 %

0.0833 hrs.

1 mins.

0.583 hrs.

10 mins.

0.333 hrs.

10 mins.

0.0833 hrs.

2 mins.

2 hrs.

15 mins.

PACS

Voice Recognition

Auto Fax 80% Us Mail 15% MD Mailbox 5%

5S

Batch Reductions

Rework Loop via Fax 10% of the time

Review Draft/Sign (Radiologist)

Print Reports (Imaging)

Send Reports (Imaging)

420 mins. 2

9 2 mins.

2

10 30 mins.

6

11

Cycle Time = 1 mins. % C&A = 95 %

Cycle Time = 1 mins. % C&A = 99 %

Cycle Time = 3 mins. % C&A = 90 %

7 hrs.

1 mins.

0.0333 hrs.

1 mins.

0.5 hrs.

3 mins.

LT = 11.3 hrs. CT = 43 mins. CT/LT Ratio = 6.32%

Rolled First Pass yield = 40%

? 2009 Karen Martin & Associatees. All Rights Reserved.

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