NHS Lothian’s innovative Lean In Lothian initiative has delivered efficiency and productivity benefits worth £6 million.
The programme, which was established to deliver significant and sustainable service improvements to benefit patients, staff and the health service is now in its fifth year.
And the recent publication of the programme’s 2009/10 annual report highlights just how successful it has been.
Since 2006, Lean In Lothian has delivered efficiency and productivity benefits worth £6 million. It has also delivered some 40 process improvement projects and trained just under 250 healthcare staff in skills to support service efficiency and effectiveness enhancements.
Major developments which have been realised through the programme over the past four years to meet national targets, attain service delivery benefits and improve patient care include the achievement of faster turnaround of pathology samples and sterile supplies, and patient access targets being met in imaging, cancer and elective services. Another key outcome has been the development of one-stop clinics for breast cancer and wheelchair services.
Over the past year Lean In Lothian has continued to deliver impressive and wide-ranging results.
Libby Tait, NHS Lothian Associate Director, Modernisation, says: “The programme’s fourth year saw us further developing capacity and capability to deliver considerable service improvements which will help NHS Lothian achieve its vision of becoming one of the country’s best, and one of the world’s top 25, healthcare providers.”
“Lean In Lothian is focused on developing the internal skills and organisational culture which encourage and enable continuous service improvement, and giving staff the opportunities to deliver more efficient services and even better patient care. Staff training therefore plays a vital role and to reflect this, our training programme has been redesigned to be better tailored to staff needs.”
Training is now shorter – comprising two three-day modules – so it is more accessible and responsive to time demands – and is geared to equip and empower trainees (or change agents as the programme calls them) to deliver a local improvement project. Enhanced post-training support systems have also been put in place for staff. New employees are now introduced to the Lean In Lothian programme at their induction to raise awareness of the aims of the initiative right from the start, and an eLearning module has been developed to allow all staff to learn its basic principles.
During the year to March 2010, 240 staff from a wide range of NHS Lothian services participated in 12 major Lean In Lothian projects, the majority of which were in acute care.
Libby Tait advises: “The projects included work on elective services to support the achievement of the 18-week referral to treatment target in St John’s Hospital theatres, diagnostic targets to be met and administration systems to be improved in paediatric gastrointestinal medicine, and enhanced procedures and protocols to be introduced in the dermatology plastic surgery skin lesions pathway.
“Community mental health issues were also addressed through projects including one on substance misuse in West Lothian. This resulted in key clinic waiting times for the service being almost halved, and clients’ access to information and advice being improved through the creation of a website.
“In addition, systems reviews were undertaken of four medicine for the elderly day hospitals; this resulted in a number of improvements which included the standardisation of assessment and care review processes. Another project focusing on complaints systems across Lothian resulted in the decision to create a central complaints ‘hub’ which will provide a single point of contact for patients. New arrangements have also been put in place to allow 100% achievement of the 3-day complaint acknowledgement target and a higher percentage of complaints responded to within 20 days.”
From its inception, patient involvement has played an important role in the Lean In Lothian programme and this has continued over the past year.
Libby Tait said: “NHS Lothian has always recognised and appreciated how invaluable the views of patients are in helping us shape services to meet their needs and expectations. Seeking feedback from service users and enabling their contribution to assessments and reviews undertaken through process improvement projects is therefore integral to Lean In Lothian. Patients’ views on many aspects such as accessibility and information provision influence the development of systems redesigns, the results of which have a significant impact on the patient experience.”
Looking ahead to the future for Lean In Lothian, an ambitious patient pathway redesign programme for older people’s services is the main focus for 2010/11. Designated a priority service redesign issue by NHS Lothian, this is involving engagement with staff teams across seven hospitals and four Community Health Partnerships and local authorities.
Libby Tait added: “We’re committed to driving forward Lean In Lothian and building on its achievements to date. Reviews of completed projects have demonstrated that they have delivered lasting benefits. We will continue to make every effort to introduce improvements from the perspective of patients and enhancing the quality of our services through the introduction of more effective processes and systems, reduced duplication, and better use of resources and staff time.”
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