Grove, Amy L., Meredith, James O., Macintyre, Mairi, Angelis, Jannis and Neailey, Kevin (2010) Lean implementation in primary care health visiting services in National Health Service UK. Quality and Safety in Health Care, Vol.19 (No.5). pp. 1-5. doi:10.1136/qshc.2009.039719

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Abstract

Background: This paper presents the findings of a 13-month lean implementation in National Hearth Service (NHS) primary care health visiting services from May 2008 to June 2009.

Method: Lean was chosen for this study because of its reported success in other healthcare organisations. Value-stream mapping was utilised to map out essential tasks for the participating health visiting service. Stakeholder mapping was conducted to determine the links between all relevant stakeholders. Waste processes were then identified through discussions with these stakeholders, and a redesigned future state process map was produced. Quantitative data were provided through a 10-day time-and-motion study of a selected number of staff within the service. This was analysed to provide an indication of waste activity that could be removed from the system following planned improvements.

Results: The value-stream map demonstrated that there were 67 processes in the original health visiting service studied. Analysis revealed that 65% of these processes were waste and could be removed in the redesigned process map. The baseline time-and-motion data demonstrate that clinical staff performed on average 15% waste activities, and the administrative support staff performed 46% waste activities.

Conclusion: Opportunities for significant waste reduction have been identified during the study using the lean tools of value-stream mapping and a time-and-motion study. These opportunities include simplification of standard tasks, reduction in paperwork and standardisation of processes. Successful implementation of these improvements will free up resources within the organisation which can be redirected towards providing better direct care to patients.

Item Type:	Journal Article
Subjects:	H Social Sciences > HV Social pathology. Social and public welfare R Medicine > RA Public aspects of medicine R Medicine > RT Nursing
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) > Warwick Evidence Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Social Sciences > Warwick Business School Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School Faculty of Science, Engineering and Medicine > Engineering > WMG (Formerly the Warwick Manufacturing Group)
Library of Congress Subject Headings (LCSH):	Primary care (Medicine) -- Great Britain, Visiting nurses -- Great Britain, Home care services -- Great Britain, Great Britain. National Health Service
Journal or Publication Title:	Quality and Safety in Health Care
Publisher:	B M J Publishing Group
ISSN:	1475-3898
Official Date:	October 2010
Dates:	Date Event October 2010 Published
Volume:	Vol.19
Number:	No.5
Number of Pages:	5
Page Range:	pp. 1-5
DOI:	10.1136/qshc.2009.039719
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	Warwick Innovative Manufacturing Research Centre (WIMRC)

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