Flow Notes: Design Workflow Before Designing Your New Facility
A Rare Opportunity
Is your organization planning a construction project? As hospitals and clinics struggle to balance rising costs with revenue threatened by reform and changing payer mix, capital investments, such as building renovation and expansion, must bring tangible savings.
As never before, preparation prior to construction should include a deliberate assessment of operational efficiencies, throughout, and flexibility to be gained. Construction, either new or renovated, offers a rare opportunity to resolve chronic process “work-arounds” and poor space utilization. An examination of workflow using Lean Principles, ahead of and during design, can be applied to effectively guide the development of improved processes, and in turn, a more durable facility. The facility design should support best practices, not vice versa, and avoid an awkward post-construction conversation with clinicians and staff, “why didn’t you consider…?”
Consider These Factors In Your Planning
- Does your design team understand the opportunities in improved process flow? Have they examined how much “waste” in current processes hinders your staff from optimal performance?
- Has a clear vision of expectations for the facility been developed? Beyond replacement, are the objectives for the new facility stated in very tangible ways, and how process flow will be improved?
- Have you examined the variation (and the waste) in process flow which could be eliminated to yield more predictable performance and more satisfied patients and staff?
- Is the concept of “standard work” or “the best and accepted practice” embraced, and considered in the design of the new facility? (This is a hurdle for some organizations, but pays remarkable benefits when achieved.)
- Does the facility plan anticipate use of visual management tools and standard placement of supplies to promote, support and sustain process flow? Have you planned for visual controls and other indicators to relay how processes flow-on plan or not on plan?
- Have you planned for “designated parking spaces” for movable equipment and Kanban for supplies to promote seamless transitions? These tools help prevent staff from searching for needed items and delays in care.
- Has there been deep involvement by the front line staff and the clinicians who “touch the processes”, and has input been facilitated in the design process to:
- uncover hidden barriers?
- discover camouflaged "work-arounds"?
- coordinate the efforts of the team providing care?
- Beyond the design process, is there a plan to operationalize the concepts imbedded into the design so the planned efficiencies are achieved? (This step is often overlooked.)
- Have you planned for using mock-ups and simulations to validate assumptions and assure the yield of a more detailed and practical design?
- Has the design anticipated evolving medical practice, technology and equipment change? (The design must intentionally provide for the flexibility necessary to accommodate those changes.)
Don't Overlook This Opportunity
These lessons have been learned by other industries and can be adopted by health care. Waste and defects can be substantially reduced. The cost of not taking these steps is often underestimated. Meanwhile, the benefits of this approach are vital to your organizational health:- Efficient and flexible use of space, and potentially less build out
- Reduced change orders due to more rigorous and effective planning
- Clarified processes, with reduced variation and greater support by the users
- Better service to your customers
Transformational improvement can be achieved with focus on workflow in the planning process, and without significant investment. Other health care organizations have done it. You can, too. Please contact me, if you are interested in learning more.