[校稿]第三篇——A Lean Transformation 精益转型
本帖最后由 小编H 于 2011-2-17 13:44 编辑
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Wisconsin hospital improves processes, changes culture
威斯康星州医院改善流程，变革文化
by Nicole Adrian, contributing editor 由妮可阿德里安，特约编辑
来源：3w.qualityprocess.com ruoshuiwei 翻译（注：初稿，需校准）
In 50 Words Or Less
• To reduce waste and improve patient satisfaction, a Wisconsin hospital turned to Six Sigma and lean.
• Hospital leaders embarked on Six Sigma Green Belt and lean training, and implemented projects to decrease costs and wait times.
• The efforts resulted in financial savings and an organizational culture change.
50字以内或更少:
•为了减少浪费，提高病人的满意度，威斯康星州医院致力于六西格玛和精益。
•医院领导着手六西格玛绿带和精益培训，并实施项目，以降低成本和减少等待时间。
•金融节余的努力和组织文化变革。
Sacred Heart Hospital CEO Steve Ronstrom first learned about lean while working on supply boats that sailed to Eskimo villages in Alaska. There, they didn’t waste a thing; they wouldn’t even throw away a piece of rope. When he later returned home and worked in a hospital, he observed tremendous amounts of waste. "The general attitude in healthcare toward waste and resources really surprised me," he said.
圣心医院的首席执行官史蒂夫罗恩斯特龙，在供应船的航行前往阿拉斯加的爱斯基摩人的村庄的途中工作时，第一次了解了精益。在那里，他们没有浪费的事情，他们甚至不会扔掉了一根绳子。当他回家后在医院工作，他观察到的垃圾数量巨大。“对医疗资源的浪费和这种一般的态度真的让我吃惊，”他说。
Later, when he joined the staff of Sacred Heart Hospital in Eau Claire, WI, lean concepts and tools were introduced to employees via connections at Honeywell and a local trade school. Ronstrom said a big part of bringing lean to Sacred Heart was getting people to be conscious of waste and process improvement, and to believe the employees needed to be part of the solution.
后来，当他加入了位于威斯康星州欧克莱尔市的圣心医院时，通过在霍尼韦尔和当地职业学校的雇员，精益的概念和工具介绍给了雇员。罗恩斯特龙说圣心医院的精益带来的很大一部分是让人们为浪费和过程改进增加意识，并且相信员工需要是解决方案的一部分。
Sacred Heart Hospital is one of 13 hospitals in the Hospital Sisters Health System, scattered throughout Wisconsin and Illinois. The hospital has been on its Six Sigma and lean journey since 2002, when leadership started looking at ways to reduce waste. Since then, numerous projects and programs have been undertaken. And—maybe most importantly—a culture change has taken place.
圣心医院是分散在威斯康星州和伊利诺伊州姐妹卫生系统的13个医院之一。当领导开始寻找方法来减少浪费时，该医院自2002年以来，一直在推行六西格玛和精益。从那时起，许多项目和方案已经进行。而且，也许最重要的是，一个文化的变革已经发生。
"As at many hospitals, error reduction was one of the key areas of interest," said Dawn Garcia, division director for medical staff/quality for the Western Wisconsin Division of Hospital Sisters Health System. And as Sacred Heart was pursuing error reduction, national interest was growing in creating greater value for patients.
“由于在很多医院，减少过失是医院利益的关键领域之一，” 西方威斯康星部医院姐妹的卫生系统司医务人员/质量总监加西亚黎明说。和圣心医院追求错误的减少，越来越多的国家利益是在为病人创造更大的价值。
Seeing how lean is applied successfully in other industries is important for bringing it into healthcare, Ronstrom said. "Hospitals with community boards have seen lean applied in manufacturing and in different industries," he said. "They’ve really encouraged and responded well to the way you can apply lean in healthcare."
了解精益如何成功应用于其他行业对医疗保健领域引进精益是重要的，罗恩斯特龙说。 “医院与社区委员会所看到的精益生产在不同行业的应用，”他说。“他们真的很好地被鼓励，并回应精益这种方式可以用在医疗保健领域。”
Bringing methods used by outside organizations—such as Honeywell and local schools—into the hospital is key, Ronstrom said. "Healthcare is insular, to a degree, and it’s good to look at what works in other industries and find people who have the programs and partner with them."
拿这些方法使用到外部组织，如霍尼韦尔和本地学校，引进医院是关键，罗恩斯特龙说。 “医疗是封闭的，在一定程度上，这是很好的看一下引进在其他行业工作的人，找到他们的合作伙伴和方案。”
Lean, in particular, is essential to address costs, empower a workforce and meet patients’ needs, according to Ronstrom. It’s also important, he added, to partner with the hospital’s physicians and implement lean in a scientific and teachable way.
精益，尤其是必须解决的成本，授权劳动者和满足病人的需要，根据罗恩斯特龙说的。同样重要的是，他补充说，与医院的医生在合作伙伴和实施的科学化和受教的方式施行精益。
"It’s imperative to have a culture of excellence," Ronstrom said, "so we can have the resilience to move to accountable care and have everyone in the building constantly looking at improvement."
“这是必须有一个优秀的文化，” 罗恩斯特龙说，“因此我们能乐观的达到负责任的照顾，并每个人都持续改进。”
Green Belt training 绿带培训
In 2004, Sacred Heart partnered with a local community college and trained about 15 hospital leaders as Six Sigma Green Belts (GBs). During the next few years, those who had been trained participated in numerous improvement projects designed to focus on patient satisfaction, and to save time and money.
2004年，圣心医院与当地的大学合作培训了约15医院领导作为六西格玛绿带（GBS）。在接下来的几年里，那些参与者被多次培训，并参加了把重点放在病人的满意度，并节省时间和金钱的项目改进设计。
One of these projects focused on finding ways to reduce meal-tray waste. The goal was to decrease by 60% the amount of waste created by late requests to change either a patient’s tray locations or diet. The results were excellent—95% of the project goal was met (the actual decrease was 57.6%), and the hospital saved $11,800 annually.
其中一个项目集中在设法减少餐托盘浪费。其目标是减少60％由已故要求更改或病人的饮食托盘位置或创建的废物量。测试结果很不错，该项目的95％的目标达到（实际下降57.6％），而医院每年节省$ 11,800。
Sacred Heart leaders continued to train Six Sigma Green Belts through early 2007. Then, the hospital’s focus turned to using lean to improve hospital processes. Garcia explained that leaders prioritize processes, and then choose tools and tactics based on those priorities.
圣心医院领导人继续培训2007年初通过六西格玛绿带。接着，医院的重点转向使用精益改善医院流程。加西亚解释说，领导者把流程区分优先次序，然后基于优先权选择工具和策略。
But that wasn’t enough, according to Garcia. To really dig deep into lean, hospital leaders considered a new ASQ training program. "We were looking for an avenue to get a core group of leaders to demonstrate lean’s impact," Garcia said.
但是这还不够，根据加西亚。要真正深入挖掘精益，医院领导考虑过美国质量协会一个新的培训项目。 “我们曾寻找一个途径获得的核心小组的领导人展示精益的影响，”加西亚说。
Sacred Heart found that avenue through ASQ’s Leading Lean Teams course. Garcia and Sue Peiffer, Sacred Heart’s performance improvement coordinator, worked with ASQ program developers to determine the training’s curriculum and design.
圣心医院发现，通过美国质量协会的精益团队课程的途径。圣心医院的执行改善协调员加西亚和苏佩弗，与ASQ的项目开发者合作，以确定培训的课程设置和设计。
Later, the hospital had the opportunity to pilot the new ASQ training. "We accepted, knowing it would be a direct line to success," Garcia said. In total, 96% of Sacred Heart leadership—about 100 individuals—were trained through Leading Lean Teams.
后来，该医院有试行ASQ新的培训机会。 “我们接受了，知道这将是一个可以直接指向成功，”加西亚说。总的来说，圣心医院96%的领导，约100人，通过精益团队训练。
The 11-week course includes four hours of virtual training and three days of activity-based classroom training. Additionally, students are assigned to read Thomas Zidel’s A Lean Guide to Transforming Healthcare1 and use ongoing personalized coaching from experienced healthcare quality experts. Lastly, those who take the training are given time to implement actual kaizen events at their organizations.
这11周的课程包括四个小时的虚拟培训和三个活动日为基础的课堂培训。此外，学员被分配到读托马斯赛德尔的转变卫生保健的精益指南和使用有经验的医疗质量专家进行个性化辅导。最后，那些参加培训者喜欢在他们组织内来落实实际的改善项目。
From the group of Sacred Heart leaders who took the training, 15 teams were established. Each team had a specific project to tackle. Teams members were selected so each team would include a mix of skills, strengths and personalities, Peiffer said. Some teams had GBs, and the individuals varied in their experience with lean and quality.
从圣心医院接受培训的团队中，建立了15个小组。每组有一个具体的项目来解决。小组成员的选择上每个小组将包括技能，长处和个性组合，佩弗说。有些队已经有绿带成员，在精益和质量有各式各样的的经验的成员。
Narrowing it down缩小下来
Before implementing the projects, the teams had to identify potential project focus areas and make sure they met the organization’s priorities, Garcia said. The teams also had to identify potential cost savings, patient value, and the likely benefit to quality metrics and outcomes. At the end of the training, facilitators had each team report its findings.
在实施项目之前，团队必须确定潜在的项目重点领域，并确保它们符合组织的优先事项，加西亚说。该小组还必须确定潜在的成本节约，病人的价值，以及可能的效益，以质量指标和成果。在培训结束时，推进者要每个小组的报告其调查结果。
"We had the attendees and members of the leadership teams identify which projects were most beneficial to the organization," Garcia said. The trained leaders had five minutes to showcase their project ideas for the other teams through graphics and videos. The audience—the other teams—rated the projects on scorecards.
“我们有参加者和领导班子成员确定哪些项目是最对组织有利的，”加西亚说。训练有素的领导人有五分钟时间通过图形和影片向其他小组展示自己项目的想法。其他的小组作为观众，在额定记分卡上的评价项目。
The scores and projects were put on a matrix (Figure 1) and from there, senior leaders selected which ones would move forward with implementation, Peiffer said.
项目的成绩项放在一个矩阵里（图1），从那里，高级领导人选择哪些项目将进一步推进执行，佩弗说。
The executive leaders’ team reviewed and endorsed three projects, and approved them for implementation:
• Outpatient registration: To increase accuracy of demographic data entry.
• Emergency department (ED) throughput: To decrease ED patient total bed time.
• Digital mammography: To reduce the reporting time, moving from 90% in 35 hours to 90% in fewer than 12 hours. This project has been completed, and the results as of January 2010 indicated 92% in fewer than 12 hours.
在行政领导小组审查并批准三个项目，并批准执行它们：
•门诊挂号：为了增加录入人口数据的准确性。
•急诊（ED）吞吐量：为了减少ED患者总床时间。
•数字化乳腺摄影：为了减少报告的时间，从90％在35小时内减少到90％少于12小时。该项目已完成， 在2010年1月的结果显示在不到12小时，占92％。
After those three projects were implemented, another of the 15 original projects, a hotel menu project, began. When the project is completed, the organization will move from a generic menu to one that is more like a restaurant menu—customized and with options. The process goal was to improve first-run tray pass accuracy from 70% to 90%. The project was successful as a pilot, and was later expanded to include the whole hospital. The project is expected to be completed early this year.
经过这三个项目得到实施，原有的15个项目中的另一个，酒店菜单项目开始。当项目完成后，该组织将从一个普通菜单一转变成一个餐厅的菜单和客人选项的定制。这一进程的目标是首次运行托盘传递精度从70％提高为90％。该项目是作为试点的成功，后来扩大到包括整个医院。该项目预计于今年年初完成。
Just because the lean training ended didn’t mean lean improvement ideas and projects ended. Despite having only undertaken four of the 15 projects, the others are still being considered.
精益培训的结束并不意味着精益改进的观念和项目改进的结束。尽管只执行了15个项目中的四个，其他的项目仍然在考虑之中。
Peiffer said, "Leaders hold quarterly sessions in which the teams report on their project progress."
佩弗说：“领导认为小组在该项目的进展上报告季度会议。“
When leaders are identified as project stakeholders or champions, they have a one-year commitment to the project to make sure everything is in place, Garcia added. Peiffer keeps track of champions and their projects, and provides weekly reports to Garcia. "I have a list that I keep checking, asking ‘Where are you now?’" Peiffer said.
当领导者作为确定项目利益相关者，或冠军，他们对项目有一个为期一年的承诺，以确保一切到达，加西亚补充说。佩弗获得了项目跟踪的冠军，他给加西亚提供每周报告。 “我有一个清单，我保持核查，问‘你现在在哪里？’”佩弗说。
Additionally, there is a centralized data repository in which individuals submit key metrics and results from their teams. Peiffer and senior leaders can look at the data at any time to make sure projects are on schedule. If not, Peiffer will ask for one-on-one updates.
此外，还有一个集中的数据库，个人提交其团队的重要指标和结果。佩弗和高级领导人在任何时候可以查看数据，以确保项目如期进行。如果没有，佩弗会要求一对一的更新。
Cultural change 文化变革
Implementing lean has led to a changed and improved organizational culture. "We were already directed to support the patients and provide quality in care," Garcia said. Observing and seeing things through the patients’ eyes helped reveal bottlenecks and opportunities to improve, she explained.
实施精益导致了组织文化的变革和进步。“我们已经把精力用在赞成向病人提供护理质量上，“加西亚说。通过观察，看病人的眼睛有助于揭示事物的瓶颈和改进的机会，她解释说。
Before undertaking lean and improving processes, Garcia said staff members had been sympathetic to waiting patients but didn’t necessarily recognize the waste that resulted from those delays. Having that patient background and understanding has really helped colleagues think and act, Garcia added.
在从事精益和改善流程之前，加西亚说，工作人员对等待的病人已具有同情，但并不一定认识从那些浪费造成的延误。有了这样的耐心和理解的背景真的可以帮助同事的思想和行动，加西亚补充说。
Sacred Heart’s lean journey has gone so well that leaders—including Garcia and Peiffer—have created a video to share the details and best practices of their journey with the sister hospitals within their health system.
圣心医院的精益之旅已经进展的非常好，领导人，包括加西亚和佩弗，创建了一个视频与他们的卫生系统内的姐妹医院分享他们旅程的细节和最佳做法。
"Many of our sister facilities are not as far along ," Garcia said. "We’ve been asked a number of questions and thought the video would be a good strategy."
“我们的姐妹医院许多设施都没有具备，”加西亚说。“我们一直被问了好多问题，通过这个视频学习将是一个很好的策略。”
Lean implementation has certainly been successful at Sacred Heart: the bottom line improved significantly, an employee engagement survey is under way, and significant cost reductions occurred, Ronstrom said.
在圣心医院实施精益无疑是成功：底线明显改善，雇员参与的调查正在进行之中，并大幅降低成本的发生，罗恩斯特龙说。
Additionally, the organization has begun showcasing lean in community outreach programs. Some managers, for example, are helping places, such as free clinics, apply lean principles and tools.
此外，该组织已经开始展现在组织外展计划精益。有些管理人员，例如，运用精益原则和工具。正在帮助义诊等地方。
Lean is now considered part of the hospitals’ process improvement, and it’s hardwired into employees, Garcia said. Peiffer said that she is receiving more phone calls from employees with ideas for lean projects. People are identifying that there are a lot more issues, and employees are excited to see a difference and make a difference with projects.
精益目前被认为是医院的过程改进的一部分，它成为员工的硬连接，加西亚说。佩弗说，她接受到雇员为精益项目的想法的越来越多的电话。人们查明有更多的问题，员工很高兴地能看到区别，并作出处理项目的差异。
Looking to the future 展望未来
Although the majority of leaders have been trained in lean and some projects have been implemented, the journey is far from over.
虽然大多数领导人已经训练了精益而有些项目已经实施，但精益旅程还远未结束。
"My priority is to get more members of the organization well versed in performance improvement tools," Garcia said. "The focus was on leaders. Now, leaders have to get tools and techniques to the teams. We want colleagues to be driving process improvement within their departments or through teams."
“我的首要任务就是要组织更对精通性能改善工具的成员，”加西亚说。 “重点是领导人。现在，领导者必须获得工具和技术的团队。我们希望同事是在自己的部门或团队内推进过程改善。”
Ronstrom said it’s important to train the next generation and have lean and quality completely embedded as part of governance and management structure. "At the management level, we have to make sure people have tools and knowledge, and that we are keeping current as lean process training improves," he said.
罗恩斯特龙说，重要的是要培养下一代，有精益和质量完全嵌入到作为治理和管理结构的一部分。“在管理水平上，我们必须确保人员熟悉工具，而且保持我们目前的精益过程培训提高，”他说。
"There’s no way we can operate without lean in healthcare today," Ronstrom said. "It’s fundamental to our operations management. Lean is here to stay."
“今天在卫生保健领域如果没有精益，那医院将无法运转，”罗恩斯特龙说。 “这是我们经营管理的根本。精益在这里永存。”
哪位组员愿意报名校稿？需要留下电话，邮箱，姓名, 预计完成时间。希望在三天内可以完成，或者提前也行。——小编H
Wisconsin hospital improves processes, changes culture
威斯康星州医院改善流程，变革文化
by Nicole Adrian, contributing editor 由妮可阿德里安，特约编辑
来源：3w.qualityprocess.com ruoshuiwei 翻译（注：初稿，需校准）
In 50 Words Or Less
• To reduce waste and improve patient satisfaction, a Wisconsin hospital turned to Six Sigma and lean.
• Hospital leaders embarked on Six Sigma Green Belt and lean training, and implemented projects to decrease costs and wait times.
• The efforts resulted in financial savings and an organizational culture change.
50字以内或更少:
•为了减少浪费，提高病人的满意度，威斯康星州医院致力于六西格玛和精益。
•医院领导着手六西格玛绿带和精益培训，并实施项目，以降低成本和减少等待时间。
•金融节余的努力和组织文化变革。
Sacred Heart Hospital CEO Steve Ronstrom first learned about lean while working on supply boats that sailed to Eskimo villages in Alaska. There, they didn’t waste a thing; they wouldn’t even throw away a piece of rope. When he later returned home and worked in a hospital, he observed tremendous amounts of waste. "The general attitude in healthcare toward waste and resources really surprised me," he said.
圣心医院的首席执行官史蒂夫罗恩斯特龙，在供应船的航行前往阿拉斯加的爱斯基摩人的村庄的途中工作时，第一次了解了精益。在那里，他们没有浪费的事情，他们甚至不会扔掉了一根绳子。当他回家后在医院工作，他观察到的垃圾数量巨大。“对医疗资源的浪费和这种一般的态度真的让我吃惊，”他说。
Later, when he joined the staff of Sacred Heart Hospital in Eau Claire, WI, lean concepts and tools were introduced to employees via connections at Honeywell and a local trade school. Ronstrom said a big part of bringing lean to Sacred Heart was getting people to be conscious of waste and process improvement, and to believe the employees needed to be part of the solution.
后来，当他加入了位于威斯康星州欧克莱尔市的圣心医院时，通过在霍尼韦尔和当地职业学校的雇员，精益的概念和工具介绍给了雇员。罗恩斯特龙说圣心医院的精益带来的很大一部分是让人们为浪费和过程改进增加意识，并且相信员工需要是解决方案的一部分。
Sacred Heart Hospital is one of 13 hospitals in the Hospital Sisters Health System, scattered throughout Wisconsin and Illinois. The hospital has been on its Six Sigma and lean journey since 2002, when leadership started looking at ways to reduce waste. Since then, numerous projects and programs have been undertaken. And—maybe most importantly—a culture change has taken place.
圣心医院是分散在威斯康星州和伊利诺伊州姐妹卫生系统的13个医院之一。当领导开始寻找方法来减少浪费时，该医院自2002年以来，一直在推行六西格玛和精益。从那时起，许多项目和方案已经进行。而且，也许最重要的是，一个文化的变革已经发生。
"As at many hospitals, error reduction was one of the key areas of interest," said Dawn Garcia, division director for medical staff/quality for the Western Wisconsin Division of Hospital Sisters Health System. And as Sacred Heart was pursuing error reduction, national interest was growing in creating greater value for patients.
“由于在很多医院，减少过失是医院利益的关键领域之一，” 西方威斯康星部医院姐妹的卫生系统司医务人员/质量总监加西亚黎明说。和圣心医院追求错误的减少，越来越多的国家利益是在为病人创造更大的价值。
Seeing how lean is applied successfully in other industries is important for bringing it into healthcare, Ronstrom said. "Hospitals with community boards have seen lean applied in manufacturing and in different industries," he said. "They’ve really encouraged and responded well to the way you can apply lean in healthcare."
了解精益如何成功应用于其他行业对医疗保健领域引进精益是重要的，罗恩斯特龙说。 “医院与社区委员会所看到的精益生产在不同行业的应用，”他说。“他们真的很好地被鼓励，并回应精益这种方式可以用在医疗保健领域。”
Bringing methods used by outside organizations—such as Honeywell and local schools—into the hospital is key, Ronstrom said. "Healthcare is insular, to a degree, and it’s good to look at what works in other industries and find people who have the programs and partner with them."
拿这些方法使用到外部组织，如霍尼韦尔和本地学校，引进医院是关键，罗恩斯特龙说。 “医疗是封闭的，在一定程度上，这是很好的看一下引进在其他行业工作的人，找到他们的合作伙伴和方案。”
Lean, in particular, is essential to address costs, empower a workforce and meet patients’ needs, according to Ronstrom. It’s also important, he added, to partner with the hospital’s physicians and implement lean in a scientific and teachable way.
精益，尤其是必须解决的成本，授权劳动者和满足病人的需要，根据罗恩斯特龙说的。同样重要的是，他补充说，与医院的医生在合作伙伴和实施的科学化和受教的方式施行精益。
"It’s imperative to have a culture of excellence," Ronstrom said, "so we can have the resilience to move to accountable care and have everyone in the building constantly looking at improvement."
“这是必须有一个优秀的文化，” 罗恩斯特龙说，“因此我们能乐观的达到负责任的照顾，并每个人都持续改进。”
Green Belt training 绿带培训
In 2004, Sacred Heart partnered with a local community college and trained about 15 hospital leaders as Six Sigma Green Belts (GBs). During the next few years, those who had been trained participated in numerous improvement projects designed to focus on patient satisfaction, and to save time and money.
2004年，圣心医院与当地的大学合作培训了约15医院领导作为六西格玛绿带（GBS）。在接下来的几年里，那些参与者被多次培训，并参加了把重点放在病人的满意度，并节省时间和金钱的项目改进设计。
One of these projects focused on finding ways to reduce meal-tray waste. The goal was to decrease by 60% the amount of waste created by late requests to change either a patient’s tray locations or diet. The results were excellent—95% of the project goal was met (the actual decrease was 57.6%), and the hospital saved $11,800 annually.
其中一个项目集中在设法减少餐托盘浪费。其目标是减少60％由已故要求更改或病人的饮食托盘位置或创建的废物量。测试结果很不错，该项目的95％的目标达到（实际下降57.6％），而医院每年节省$ 11,800。
Sacred Heart leaders continued to train Six Sigma Green Belts through early 2007. Then, the hospital’s focus turned to using lean to improve hospital processes. Garcia explained that leaders prioritize processes, and then choose tools and tactics based on those priorities.
圣心医院领导人继续培训2007年初通过六西格玛绿带。接着，医院的重点转向使用精益改善医院流程。加西亚解释说，领导者把流程区分优先次序，然后基于优先权选择工具和策略。
But that wasn’t enough, according to Garcia. To really dig deep into lean, hospital leaders considered a new ASQ training program. "We were looking for an avenue to get a core group of leaders to demonstrate lean’s impact," Garcia said.
但是这还不够，根据加西亚。要真正深入挖掘精益，医院领导考虑过美国质量协会一个新的培训项目。 “我们曾寻找一个途径获得的核心小组的领导人展示精益的影响，”加西亚说。
Sacred Heart found that avenue through ASQ’s Leading Lean Teams course. Garcia and Sue Peiffer, Sacred Heart’s performance improvement coordinator, worked with ASQ program developers to determine the training’s curriculum and design.
圣心医院发现，通过美国质量协会的精益团队课程的途径。圣心医院的执行改善协调员加西亚和苏佩弗，与ASQ的项目开发者合作，以确定培训的课程设置和设计。
Later, the hospital had the opportunity to pilot the new ASQ training. "We accepted, knowing it would be a direct line to success," Garcia said. In total, 96% of Sacred Heart leadership—about 100 individuals—were trained through Leading Lean Teams.
后来，该医院有试行ASQ新的培训机会。 “我们接受了，知道这将是一个可以直接指向成功，”加西亚说。总的来说，圣心医院96%的领导，约100人，通过精益团队训练。
The 11-week course includes four hours of virtual training and three days of activity-based classroom training. Additionally, students are assigned to read Thomas Zidel’s A Lean Guide to Transforming Healthcare1 and use ongoing personalized coaching from experienced healthcare quality experts. Lastly, those who take the training are given time to implement actual kaizen events at their organizations.
这11周的课程包括四个小时的虚拟培训和三个活动日为基础的课堂培训。此外，学员被分配到读托马斯赛德尔的转变卫生保健的精益指南和使用有经验的医疗质量专家进行个性化辅导。最后，那些参加培训者喜欢在他们组织内来落实实际的改善项目。
From the group of Sacred Heart leaders who took the training, 15 teams were established. Each team had a specific project to tackle. Teams members were selected so each team would include a mix of skills, strengths and personalities, Peiffer said. Some teams had GBs, and the individuals varied in their experience with lean and quality.
从圣心医院接受培训的团队中，建立了15个小组。每组有一个具体的项目来解决。小组成员的选择上每个小组将包括技能，长处和个性组合，佩弗说。有些队已经有绿带成员，在精益和质量有各式各样的的经验的成员。
Narrowing it down缩小下来
Before implementing the projects, the teams had to identify potential project focus areas and make sure they met the organization’s priorities, Garcia said. The teams also had to identify potential cost savings, patient value, and the likely benefit to quality metrics and outcomes. At the end of the training, facilitators had each team report its findings.
在实施项目之前，团队必须确定潜在的项目重点领域，并确保它们符合组织的优先事项，加西亚说。该小组还必须确定潜在的成本节约，病人的价值，以及可能的效益，以质量指标和成果。在培训结束时，推进者要每个小组的报告其调查结果。
"We had the attendees and members of the leadership teams identify which projects were most beneficial to the organization," Garcia said. The trained leaders had five minutes to showcase their project ideas for the other teams through graphics and videos. The audience—the other teams—rated the projects on scorecards.
“我们有参加者和领导班子成员确定哪些项目是最对组织有利的，”加西亚说。训练有素的领导人有五分钟时间通过图形和影片向其他小组展示自己项目的想法。其他的小组作为观众，在额定记分卡上的评价项目。
The scores and projects were put on a matrix (Figure 1) and from there, senior leaders selected which ones would move forward with implementation, Peiffer said.
项目的成绩项放在一个矩阵里（图1），从那里，高级领导人选择哪些项目将进一步推进执行，佩弗说。
The executive leaders’ team reviewed and endorsed three projects, and approved them for implementation:
• Outpatient registration: To increase accuracy of demographic data entry.
• Emergency department (ED) throughput: To decrease ED patient total bed time.
• Digital mammography: To reduce the reporting time, moving from 90% in 35 hours to 90% in fewer than 12 hours. This project has been completed, and the results as of January 2010 indicated 92% in fewer than 12 hours.
在行政领导小组审查并批准三个项目，并批准执行它们：
•门诊挂号：为了增加录入人口数据的准确性。
•急诊（ED）吞吐量：为了减少ED患者总床时间。
•数字化乳腺摄影：为了减少报告的时间，从90％在35小时内减少到90％少于12小时。该项目已完成， 在2010年1月的结果显示在不到12小时，占92％。
After those three projects were implemented, another of the 15 original projects, a hotel menu project, began. When the project is completed, the organization will move from a generic menu to one that is more like a restaurant menu—customized and with options. The process goal was to improve first-run tray pass accuracy from 70% to 90%. The project was successful as a pilot, and was later expanded to include the whole hospital. The project is expected to be completed early this year.
经过这三个项目得到实施，原有的15个项目中的另一个，酒店菜单项目开始。当项目完成后，该组织将从一个普通菜单一转变成一个餐厅的菜单和客人选项的定制。这一进程的目标是首次运行托盘传递精度从70％提高为90％。该项目是作为试点的成功，后来扩大到包括整个医院。该项目预计于今年年初完成。
Just because the lean training ended didn’t mean lean improvement ideas and projects ended. Despite having only undertaken four of the 15 projects, the others are still being considered.
精益培训的结束并不意味着精益改进的观念和项目改进的结束。尽管只执行了15个项目中的四个，其他的项目仍然在考虑之中。
Peiffer said, "Leaders hold quarterly sessions in which the teams report on their project progress."
佩弗说：“领导认为小组在该项目的进展上报告季度会议。“
When leaders are identified as project stakeholders or champions, they have a one-year commitment to the project to make sure everything is in place, Garcia added. Peiffer keeps track of champions and their projects, and provides weekly reports to Garcia. "I have a list that I keep checking, asking ‘Where are you now?’" Peiffer said.
当领导者作为确定项目利益相关者，或冠军，他们对项目有一个为期一年的承诺，以确保一切到达，加西亚补充说。佩弗获得了项目跟踪的冠军，他给加西亚提供每周报告。 “我有一个清单，我保持核查，问‘你现在在哪里？’”佩弗说。
Additionally, there is a centralized data repository in which individuals submit key metrics and results from their teams. Peiffer and senior leaders can look at the data at any time to make sure projects are on schedule. If not, Peiffer will ask for one-on-one updates.
此外，还有一个集中的数据库，个人提交其团队的重要指标和结果。佩弗和高级领导人在任何时候可以查看数据，以确保项目如期进行。如果没有，佩弗会要求一对一的更新。
Cultural change 文化变革
Implementing lean has led to a changed and improved organizational culture. "We were already directed to support the patients and provide quality in care," Garcia said. Observing and seeing things through the patients’ eyes helped reveal bottlenecks and opportunities to improve, she explained.
实施精益导致了组织文化的变革和进步。“我们已经把精力用在赞成向病人提供护理质量上，“加西亚说。通过观察，看病人的眼睛有助于揭示事物的瓶颈和改进的机会，她解释说。
Before undertaking lean and improving processes, Garcia said staff members had been sympathetic to waiting patients but didn’t necessarily recognize the waste that resulted from those delays. Having that patient background and understanding has really helped colleagues think and act, Garcia added.
在从事精益和改善流程之前，加西亚说，工作人员对等待的病人已具有同情，但并不一定认识从那些浪费造成的延误。有了这样的耐心和理解的背景真的可以帮助同事的思想和行动，加西亚补充说。
Sacred Heart’s lean journey has gone so well that leaders—including Garcia and Peiffer—have created a video to share the details and best practices of their journey with the sister hospitals within their health system.
圣心医院的精益之旅已经进展的非常好，领导人，包括加西亚和佩弗，创建了一个视频与他们的卫生系统内的姐妹医院分享他们旅程的细节和最佳做法。
"Many of our sister facilities are not as far along ," Garcia said. "We’ve been asked a number of questions and thought the video would be a good strategy."
“我们的姐妹医院许多设施都没有具备，”加西亚说。“我们一直被问了好多问题，通过这个视频学习将是一个很好的策略。”
Lean implementation has certainly been successful at Sacred Heart: the bottom line improved significantly, an employee engagement survey is under way, and significant cost reductions occurred, Ronstrom said.
在圣心医院实施精益无疑是成功：底线明显改善，雇员参与的调查正在进行之中，并大幅降低成本的发生，罗恩斯特龙说。
Additionally, the organization has begun showcasing lean in community outreach programs. Some managers, for example, are helping places, such as free clinics, apply lean principles and tools.
此外，该组织已经开始展现在组织外展计划精益。有些管理人员，例如，运用精益原则和工具。正在帮助义诊等地方。
Lean is now considered part of the hospitals’ process improvement, and it’s hardwired into employees, Garcia said. Peiffer said that she is receiving more phone calls from employees with ideas for lean projects. People are identifying that there are a lot more issues, and employees are excited to see a difference and make a difference with projects.
精益目前被认为是医院的过程改进的一部分，它成为员工的硬连接，加西亚说。佩弗说，她接受到雇员为精益项目的想法的越来越多的电话。人们查明有更多的问题，员工很高兴地能看到区别，并作出处理项目的差异。
Looking to the future 展望未来
Although the majority of leaders have been trained in lean and some projects have been implemented, the journey is far from over.
虽然大多数领导人已经训练了精益而有些项目已经实施，但精益旅程还远未结束。
"My priority is to get more members of the organization well versed in performance improvement tools," Garcia said. "The focus was on leaders. Now, leaders have to get tools and techniques to the teams. We want colleagues to be driving process improvement within their departments or through teams."
“我的首要任务就是要组织更对精通性能改善工具的成员，”加西亚说。 “重点是领导人。现在，领导者必须获得工具和技术的团队。我们希望同事是在自己的部门或团队内推进过程改善。”
Ronstrom said it’s important to train the next generation and have lean and quality completely embedded as part of governance and management structure. "At the management level, we have to make sure people have tools and knowledge, and that we are keeping current as lean process training improves," he said.
罗恩斯特龙说，重要的是要培养下一代，有精益和质量完全嵌入到作为治理和管理结构的一部分。“在管理水平上，我们必须确保人员熟悉工具，而且保持我们目前的精益过程培训提高，”他说。
"There’s no way we can operate without lean in healthcare today," Ronstrom said. "It’s fundamental to our operations management. Lean is here to stay."
“今天在卫生保健领域如果没有精益，那医院将无法运转，”罗恩斯特龙说。 “这是我们经营管理的根本。精益在这里永存。”
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qys0418 (威望:0) (辽宁 大连) 机械制造 经理
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