Thomas Walsh, of BWHC Analytics, Planning and Process Improvement, speaks at the Lean presentations in July.

For Dorothy Goulart, MS, RN, director of Process Improvement for BWHC Analytics, Planning and Process Improvement (APPI), it’s always gratifying to see positive reactions of clinicians, staff and managers when they complete the Lean Practitioner Program.

The program, offered by APPI, teaches leaders how to engage staff in process improvement within a department, practice or unit. The training lasts four months, culminating in participants applying what they learn in the classroom to real-life improvement projects at BWH and Brigham and Women’s Faulker Hospital.

“Through Lean improvement projects, training and coaching, our BWHC Process Improvement team has touched nearly every department, inpatient unit, ambulatory practice and community health center,” said Goulart, who retires this month. “Lean is about continual learning on how to help people see and understand the causes of process problems and to work together with colleagues to solve them.”

Staff members from Process Improvement serve as team coaches. More than 300 BWHers have participated in Lean since 2008.

“The Lean Practitioner Program trains you to look in places you might not think would make your work more efficient,” said Steven Bloom, MSc, director of Environmental Affairs, who participated in one of the program’s two sessions this year with colleagues from BWH Facilities and Operations. “Small changes in sequences, positioning or timing can yield noticeable improvements.”

Past Lean projects have included improving the discharge time for patients, streamlining billing processes, improving the Occupational Health Services clearance process for new hires and providing a safer, more efficient way to administer IV medications.

Tools for Today and Tomorrow

In June, nine teams of directors and managers from Facilities and Operations presented Lean projects they had proposed and implemented during the four-month course. Projects ranged from decreasing the time it takes to valet a car at BWH to improving times for patient tray assembly for room service.

John Pierro, senior vice president of Facilities and Operations, wanted his staff to participate in Lean because he knows its benefits firsthand.

“I was trained in Lean 15 years ago and I’ve carried the knowledge with me in all of my positions since then,” he said. “The ability to figure out workflow and to get through a day without wasting precious resources allows us to focus more time on the patient care experience. Lean, from a manager’s perspective, gives staff a series of tools and techniques to become more efficient and effective.”

Paula Barry, director of Materials Management, and Therese Breen, a Materials Management manager, worked together to improve the process of making sure  slings are ready for patients who need them. They said the program provided them with the tools to put process improvements in place based on facts instead of assumptions.

Pierro said the beauty of Lean training is that the concepts are implemented as groups move through the program. He stressed that projects that go through Lean are not completed and then forgotten.

“The have a real impact,” Pierro said. “The projects are done on a scalable, pilot basis, and when there is success and sustainability, they are immediately pushed out to the rest of the hospital.”

Patrick Hubbard, operations manager of BWH Patient Dining Services, agreed that the benefits of being trained in Lean principles are long-lasting. Hubbard and colleagues from BWH Food Services received Lean training earlier this year.

“They give you fresh eyes to look at how your workflow can run at peak performance,” he said. “The Lean program was a great experience and provided me with tools I can use now and in the future.”

John Rossi, MBA, of Process Improvement, guided the teams. He said it was exciting to see how each team worked to define and diagnose a problem and then figure out how to implement changes and solutions.

“Facilities and Operations is well on its way to fostering a culture of continual improvement,” Rossi said. “I’m excited to hear updates from the teams as the projects continue to advance.”