Example: Surgery at Hosp

AS IS VSM MINFO

Information Flow

Follow Patient Nth

Process Map -->

High Level Map - Major Steps/ Functions

Material Flow/ Service

Cycle time/ unit or
Flow Data Window -->
process time per pt.
Manpower

Time & Motion Study Timeline --> 30

Make a Video of entire process
and drill down all the micro
activities

VA/ NVA analysis 30 Waiting on call/ counter

Analyse Phase
VA
NVA Req
NVA Pure
Mr. TIMWOODS
 1. Online tool for
Solutions estiamating the
appointment

TO BE Map

Information Flow

Follow Patient Nth

Process Map -->

High Level

Material Flow/ Service Flow

Data Window -->
Manpower

Timeline --> 0

Implement the solution. Will prepare the post improvement map

 Example: Surgery at Hospital
P1 - Cluster of minor activities

Raw Material Purchase/ Resource Allocation

Counter
P1 - Cluster of activities

Schedule
Appointment

People will wait for admission

10

1
300 Minutes
10
300

30 patinet data - avg time = 10 minutes

1. Check Avaib. Of appointment - 1 1. Waiting for Dr to call - 280 - 2
2. Move towards corridor/
2. Availb of Dr. check - 1
room / Dr Room - 20
3. fill in Patient details - 2

4. Check ID proof - 1

5. Advance Payment - 1
6. Insurance/ TPA check - 2
7. Give confirmation slip - 2
 1. Intimation of admission time
1. act 1,2,3,4 can be merged online tool
2. reduce the moving time
2. Insurance and confirmation slip can be part of this tool
effecitive layout and assistance
3. online. UPI or other payment options, merge with the
for directions of room, ensure
tool
lifts are working

ECRS - Eliminate, Combine, Re-arrange/ Reduce, Simplify

Visibility of Dr. to staff and Patient on app

Schedule Appointment App

P1 - Cluster of activities

Schedule
Appointment

5
0

5
60
1 pt
 Tier 3 City

Information Flow
Daily Order Forecast

Order Copy/ Information

P2

Admission

140

2
480 Minutes
140
480

1. Admission form filling - 20 1. Patient Prepare for Surgery - 60

2. Moving towards allocated bed/
room - 10 2. Wait for Surgeon- 240
3. Set up in room/ bed - 10 3. Wait due to test reports are delayed - 120
4. Primary health checks/ tests -
4. Anaesthesia - 60
100

Insurance Process
 1. act 1 is merged in tool make it
online,
2. room can be setup prior to pt
comes to room
3. assistance for moving
1. effective scheduling for admission, hence
waiting can be reduced
2. make test lab efficient by new project

educe, Simplify

Information Flow
Online System

P2

Admission

100
2

100
150
3-4 pts
LSL = 4 min USL - 8 min, Target - Cpk upper = 0.666666666666667

30 cups of coffee Avg - 10.5 minSigma leve Mgmt

Mgmt says - 12 pt in a day

Customer Demand / Order/ Patient Load Estimation net operating time - 22 hr
1.83333333333333

P3 P4

Procedure/ Discharge
Surgery

30 1,2,3,4,5,6,7,8 150

2 1
600 minutes
30 150
600

100 Pts Avg Discharge time = 150 minutes

1. Quick review of reports - 2 1.Post surgery observation - 300 0. Approval from surgeon - 30

2. mark the area - 3 2. Waiting - 300 1. Discharge form filling - 20

3. local anaesthesia - 2 2. No dues - 5

4. cut the skin - 5 3. billing - 5

5. removal of apendix - 8 4. ambulance arrangement - 30

6. clean betadine - 2 5. transfer to ambulance - 20
7. Stitches -2
8. dressing -2
9. operation notes - 4
 1. Discharge time should be quick so
1. Approval can be online
the waiting can be reduced.
2. form filling, no dues, act3 & 4
2. target of half time reduction
they can be online or may be
3. efffective com with insurance
parallel in waiting in discharge
partners

Digital Customer Demand / Order/ Patient Load Estimation

P3 P4

Procedure/
Discharge
Surgery

30 60
2 2

30 60
300
1-2 pts
110 Takt Time Desired rate 1 pt at 110 minutes

Before Improvement
Minutes Hrs
Total Process Time 330 5.5 Total Process
Total Delay time 1410 23.5 Total Delay ti

Total Lead Time 1740 29 Total Lead Time

Process Cycle Efficiency -
19.0% Process Cycle Efficiency
PCE
Process Cycle Efficiency 19%
 Planned To Be Map

Total Process Time 195 3.25

Total Delay time 510 8.50
Total Lead Time 705 11.75
Process Cycle Efficiency 28%
 Demand 1,000 injection type A are required per week
Demand per day 200 injections per day
Current supply 100 injections per day

2 shifts = 16 hours 15 hrs is net op time

Takt time Net opeating time/ Dema 15 Hrs/ 200

Current cycle tim15 hrs/ 100 injection 9

Actual Achievement

Planned To Be Map

195 3.25 4
510 8.5 14

705 11.75 18

0.276595744680851
28% 22%
Demand 1,000 injection type A are required per week
Demand per day 200 injections per day
Current supply 100 injections per day

2 shifts = 16 hours 15 hrs is net op time

Takt time Net opeating time/ Dema 15 Hrs/ 200

Current cycle tim15 hrs/ 100 injection 9

4.5
4.5
 Problem Why 1 Validation Why 2
1. Lack of trust on vaccine Y 1. misinformation
2. side effects

2. Lack of infra N 3. lack of authentic reports on vaccine

4. lack of similar past - never taken

vaccine
Vaccine Coverage is 3. Lack of awareness N 5. Culture blockage
low
4. Lack of doses N

5. Not getting the approval N

6. Less appointments avlbl Y 1. due to govt. age criteria

2. location accesbility issues
3. insufff avlblity of vaccine
validation Why 3
Y
N

Y
N
N