Read Chapter 3 in Delisle carefully “Principle 2: Map the Value Stream”. I note specific pages from these readings in the instructions below to assist you with each section of this assignment.
In this assignment complete the following steps:
Identify a healthcare process. See the example in:”Chapter 3 Principle 2: Map the Value Stream” (see attachment in Week 3). The process can include a patient, such as the example of a patient visit for a PCP exam. Or, it may include a process that does not involve a patient, such as a process for completing lab work. Ideally, you will select a process that you can observe in your current place of employment. If you are not employed, think of a past job you had and an example of a process in that setting. If you have no experience working in healthcare, then you can create an imaginary example. In that case I recommend you use the example of a patient who makes a visit for a PCP exam and then is referred to a Behavioral Health Consultant (BHC) for a “warm handoff” (meaning the physician walks the patient to the BHC in a clinic exam room, introduces patient to the BHC, and leaves the patient with the BHC for an evaluation).
Complete a Value Stream Map. Begin with a process map of the current state(see pages 33-35). The current state is the process as it currently stands; what actually takes place, not what should take place. The map should include a high-level process map and a midlevel process map. Include the time spent waiting in between steps in the process map.
TIPs for completing a Value Stream Map using Village Health Partners in Plano, TX. Website: https://villagehealthpartners.com/
USEhttp://lucidchart.zendesk.com/ to create the Value Steam Map. IT IS FREE IF YOU REGISTER
Estimate the cycle time needed to complete each step in the process map. Cycle time is the time needed to complete a specific process step. See Figure 3.7 on page 36.
Calculate a First-Pass Yield (FPY)for each step in the process and the overall process FPY yield. See page 37. The FPY is simply an estimate of the percentage of time that a process step is performed correctly the first time. Examples: Checking in with the receptionist, completing a PHQ-9 depression screen, having vital signs taken. The overall FPY is calculated by multiplying each individual step FPY (see Figure 3.8 page 37).
Evaluate Value Added (VA) versus Non-Value Added (NVA) activity for each process step.Carefully read the section “Identify Waste” in Delisle “Executing Lean Improvements” Chapter 2 pages 17-27 . Identify 3 key categories of VA and NVA based on the definitions in this section:
- “VA activities” = activities that performed during the production or delivery of the service that increase it’s value to the customer.
- “NVA required” = NVA activities performed during the production or delivery of a service that use time and resources but do not increase value to the customer, but are required due to legal, regulatory, accreditation or other requirements.
- “Waste” = NVA activities performed during the production or delivery of a service that use time and resources but does not increase value to the customer and is not required for legal, regulatory, accreditation or other reasons.
- There are 8 types of Waste using the mnemonic DOWNTIME (see pages 17-27 in Delisle)
- Not utilizing peoples abilities
viii. Excess processing
Complete VSM Calculations(See box on top of page 44)
- Cycle time
- Wait time
- Lead time
- Value-adding ratio (VA time)/(Lead time)
- First-pass yield: multiple every process step FPY
Identify opportunities for improvement based on the FPY and NVA activities. This section of the assignment should be a written narrative summary. Use the “Case Study” example on page 57 in Delisle as an example. Simply describe what process improvements you have identified based on the VSM that can improve cycle time and decrease waste. Do include the VSM steps and calculations to identify problem areas and propose solutions in this narrative. Be brief and do not go into excessive detail on your plan for improvement. A more detailed plan will be required in QI Assignment #2 in this class when you complete a PDSA. This written narrative should be 1 – 2 pages in length. Use APA Style and good grammar for narrative sections. References are not required for this narrative. However, if you would like to add a relevant reference you may do so.