Lean Healthcare Academy Projects
| Project Title | Issue |
| Colposcopy Pathway | Quality assurance report from the cancer screening programme identified problems, including: waiting too long for appointments, high follow up DNA rate, weak performance data collection, complex referral process |
| Orthopaedics 18 weeks | Mapping the orthopaedics referral to treatment, with an aim to redesign the pathway to ensure all patients are seen with the 18 week target |
| A&E 6S | Improving the ergonomics of the A&E resus room |
| A&E Waiting times | Setting a local 2 hour target, exploring how there may be improvements on the current 4 hour waiting times |
| MHRA Alerts | Inconsistency in the notification of action taken in relation to the actioning of alerts issued by MHRA |
| New Paediatric Referrals | Concern over long process for new referral to paediatric out patient department - possibly responsible for DNAs |
| Pre-op Assessment | SPI walk around identified scope for improving process flows in pre-op assessment |
| Complaints Procedure | Currently not meeting 25 day response target in a large number of complaints |
| ENT & EYE Patient Administration Process | Long standing problems with patient administration processes |
| Cancer Services/ Pathology | To assess whether laboratory tests are being used appropriately and whether effective cost savings could be made within Haematology and Oncology Services |
| Ophthalmology 18 Weeks | There is currently no clear pathway/process for the glaucoma pathway and up till now no data collection methodology |
| Trauma Orthopaedics | Dysfunctional trauma patient pathway. Delays in patients receiving emergency surgery. Problems with theatre utilisation. Long length of stays. High levels of Orthopaedic patients outlied to non orthopaedic wards |
| Outpatients Process 18 Weeks | The outpatient pathway is very complex and has many inbuilt delays- leading to problems with 18 Weeks |
| PCT MSK Provider Services | Multiple musculo-skeletal (msk) services across the health economy - in various stages of set up - which all operate slightly differently |
| Breast Cancer | Introduction of 2 week OPD wait for all Breast Patients by March 2008. |
| Lung Cancer | Recent YCN thoracic pathway meeting requested all unit MDT to review their pathways and submit action plan on how to improve the diagnostic pathway, ensure compliance with YCN network pathway, ensure robust measures for monitoring. |
| Endoscopy Store Room | The volume of stock has increase as more procedures are done and practices change. Consequently items are moved, squeezed between others or spread to other areas of the department. Urgent orders are expensive and time consuming for endoscopy and supplies. Overstock impacts on the department budget. |
| Social Care Information Systems | Increasing amount of forms, bureaucracy and "managerialism" to complete the social work task. Information systems not sufficiently integrated to prevent the need for several data bases needing to be checked and information collected manually to be able to report on performance indicators and plan services at a case, team and unit manager level. |
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Social Care Administration |
Two Child and Family teams currently based in one building but separate from other teams and admin support buildings. Issues around efficiency of the service delivery in terms of dealing with admin and assessment over this split site. Initial concerns tend to be centered on lack of admin support but this may not be the issue. |
| Children's Residential Homes Maintenance | Recent Inspection reports have highlighted delays in completing repairs in children's residential homes. |
| CAMHS | To understand and clearly define the CAMHS service and communicate internally and externally, specifically what it does and does not provide. This will be facilitated by mapping out the service ("as is") and then redesigning the service into a future state. An action plan to move from "as is" to future state will be generated. |
| Orthodontics | Long waits in Orthodontics with the potential to breach the 18 weeks RTT target |
| Adult Services | Debate re-level of human resource requirements - particularly administration - within Adult Protection referral and case work management processes. |
| Medical Records | Highlight the current state of Medical Records. Use Lean techniques to improve efficiency and effectiveness |
| PCT Data Analysis | Lots of data being collected, some duplicated, most not used and very little action on the data collected. Totally redesign the data collection looking at what is collected, who collects it, why and then look at triangulating the data effectively and action it. |
| CATS Referrals | To review referral and booking management systems and processes that take place between the referral information centre and the CATs services. There are what seem to be a number of unnecessary steps/ hand offs between the departments. Lean, streamlined process needed. |
| Continence | Aim to address waiting times for assessment; reduce the pressures on the continence specialist nurses and thus improve patient care and journey. |
| Pallative Care | The patient journey needs to be understood, particularly in relation to the statutory and voluntary services which are involved in the care and support available to this client group and their carers. The factors which result in admission to hospital need to be unpicked and key elements analysed. There is evidence which strongly suggests that many admissions occur 'out of hours', that is when daytime services are not available and general practitioner cover is given by an emergency services. Access to services close to home and preferred priorities for care reinforce the need to understand this matter and develop a strategy to enable more people to die in their place of choice and thereby reduce admission rates to acute hospital settings. |
| CASHA Amalgamation | Amalgamation of the Clinic Administrator & School Health Administrator teams to provide a complete 0 - 16 admin service. |
| Orthopaedic Pathway | Orthopaedic capacity is presenting a number of challenges in our ability to meet demand and sustain an 18 week patient pathway. We are currently comissioning capacity from the independent sector and would like to exmaine how we can redesign services in order to better meet demand. |
| Diabetic Foot Clinic | The aim is to streamline working to allow each team member to work effectively, whilst still delivering high quality patient care. |
| Paediatric Therapies | Need to identify current working practices and the problems these may create for both staff and children and their families. Explore options for changed ways of working for the benefit of staff and key stakeholders. Team to be very clear about its core and added value business and to offer equity, transparency and clarity in service provision. The team should be able to evidence efficiency in the context of use of resources and activity linked to measurable outcome and costs. |
