Article114. Designing Daily Plans & Hospital Reorganization

Designing Daily Plans & Hospital Reorganization 

How to get started Designing Daily Plans and Hospital reorganizations. This is a quick look at the decisions to be made and how they can be implemented.

Selecting the Routine Procedure to Start With
1. In Article 113. I have listed 15 possible Procedures that appear to fit the category of being routine and relatively safe.  I would select an outpatient Procedure first because it is less expensive when the its time to reorganize the hospital facility.

2. The Enterprise Lean Team (aka Continuous Improvement Team) must be in place and a part of the Procedure team selected and meet at least once a week. More meetings will be required as the design of the Daily Plan progresses.

3.  Introduce the Lean Team (CI Team) to the concept of the Daily Plan and the reorganization of facilities to support the Daily Plan. Objective to change a low patient volume/high cost Procedure into a high patient volume / low cost Procedure.

4.  The selected Procedure is an entirely separate Procedure from all other Procedures in a hospital environment completely staffed with its own facilities. The reason for not having shared facilities is that the Scheduling would destroy the balanced operations of the selected Procedure.

5. The most basic element driving the design is Patient volume.  An entire metropolitan area may be available for certain procedures due to the low cost of the Procedure.  This will drive the design of the daily plan to handle more volume and will also increase the facilities required. Early on a Patient Volume survey should be conducted for each of the procedures in the metro area identifying overall patient volume and those expected to use the new facility.

For lower patient volume two Completely separate Procedures may be designed using the same facility.  The staff would be trained to do two separate Procedures with two separate Daily Plans alternating between them to keep patient volume stable.  



What’s needed to build a Daily Plan?
1.  Precise times for all the processes done must be known.  To these times a increase of 25% is added as a protection from unintended delays. Remember the objective is to work smarter not harder savings come from the continuous operation of the process not from the speed of the process.

2.  First take the time of the doctor or surgeons process as a base time identifying how many patient operations can be done in one day. Then identify all processes leading up to the surgery and those following the surgery.  For example if a nurse requires twice as much time as the surgery process then two nurses will be required each preparing a different patient in a different room (two Rooms Required). The resulting Daily Plan will balance all the processes allowing no one to wait on another employee.
Patient backlog means that the staff does not wait on patients.  If work times can not be balanced then the extra time a staff person has can be designated as “Preparation Time”.

3.  With a sufficient backlog of patients the Daily Plan becomes a smooth running operation virtually eliminating Management intervention for budgeting and Scheduling.  Supplies are ordered automatically.


 Hospital Reorganization
1.  If a general hospital is to be reorganized planning for Hospital reorganization should not be under taken until all the Procedures using the hospital facility are known and least most of them have their Daily Plans completed.

2.  If several Procedures are using the same hospital facility then the hospital reorganization will encompass all of the Procedures supporting their Daily plans.

3.  If the Procedures can be separated into separate clinic facilities then the reorganization process becomes much simpler.  Ref: Cataract Surgery Clinic proposed in Article 110 and Article 111. Designing a High Patient Volume Low Cost Hospital.

Contact Lawrence Rosier
Lawrence Rosier Consulting
12143 Cedar Grove Rd.
Rolla, Missouri 65401
573 578 4716
lawrencerosier4@Gmail.com