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Trinity Health Harnessing Lean Tools

Date:  April 17th, 2015

Contact/Phone:  Mary Muhlbradt
(701) 857-5116
Fax: (701) 857-5683

e-mail:   Mary Muhlbradt

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(MINOT, ND) - Management practices originally associated with manufacturing are being used by Trinity Health to enhance care and improve efficiency.

Staff Development Director Shelley Semrau says "Lean" processes are being used in more than a dozen departments ranging from Emergency/Trauma to medical nursing.

Lean tools engage front line staff in a process that analyzes all of the steps involved in delivering patient care. The objective is to identify actions that waste time or resources, or simply don’t add value for patients.

"One of the tools we use is Value Stream Mapping where department personnel map out all of the activities associated with delivering care in that area from the time the patient arrives until the patient is discharged," Semrau explains. "We then look for opportunities for improvement such as standardizing supplies or reviewing PAR (preset) levels to ensure that staff never have to go searching for an item."

Other Lean tools include a system for keeping an orderly, productive workplace and the use of Key Performance Indicator (KPI) boards to help departments monitor progress.

"The whole premise behind the Lean process is rapid cycle improvement," Semrau says. "You achieve that by measuring daily and having leadership in the workplace."

The KPI boards, according to Semrau, let departments track progress by establishing key performance indicators and setting targets. The board is updated daily. If a target is met, it’s shaded green; if the target is missed, it’s shaded red and additional information is entered such as the date, location, and an explanation of why the goal was missed. Staff also fill out an action sheet spelling out who is going to do what and when to fix whatever the issue happened to be.

The boards then become the central focus of the daily Gemba walk, a Japanese term for "the real place" or "where the work is occuring."

"What happens is that every day senior leadership goes on a Gemba walk to a place with a KPI board to see how they did. The staff reports on the last 24 hours of activity and whether they achieved their metrics for safety, quality, etc. There is Q & A and some discussion about what issues were encountered and what strategies for improvement will be implemented," Semrau said.

She notes that Lean tools are being used to improve patients’ experience as they move through the Emergency Trauma Center. Surgery, Laboratory Services, Radiology, Admitting and the Newborn Intensive Care Unit are also incorporating the various tools into their practices.

She adds that in terms of an overall objective Trinity Health is using the Lean processes to achieve improvement in four distinct areas: patient outcomes, patient satisfaction, quality of work life and financial performance. SPACE index.php