A new collaboration between the University of Warwick and the NHS Institute for innovation and improvement Warwick CSI or clinical systems improvement will enable healthcare professionals to study the lean manufacturing philosophy and techniques used in the automotive and aviation industries in order to deliver better quality patient care.
Here's Matthew Cooke professor of emergency medicine to explain more more accesory is about
learning lessons from other sectors and applying them to health particularly by looking at the process of care rather than the specific treatments so how can we design the system to give the best care and the safest care.
I'm a clinician what I'm interested in is the quality of care and if you improve the quality of care you actually improve all those other things that other people are interested in such as the cost of the care
I'm Don Berwick I'm a pediatrician and head of the Institute for Healthcare Improvement which is an American based NGO that works on improving healthcare systems all over the world and for years
I've been interested in the idea of improving healthcare by improving the systems that deliver health care.
Lean thinking or lean production is a branch of improvement that developed outside healthcare and industries that figured out how you can have kind of waste-free production do away with waiting times do away with inventories do away with wasted efforts on the part of staff and employees we can bring those same concepts of developing really perfect patterns of work to support the workforce so they're not wasting their time we're not wasting patients time when always these supplies so costs can fall and quality rise at the same time one of the key issues when twelve designed it was safety and quality were
the linchpin of it all and simple things such as actually if there's six different people seeing a patient they have to hand over to another person who hands over to another one another and each time we hand over there's an opportunity there for information to get lost and therefore a safety issue if someone is allergic to a drug house and it doesn't get passed on to the next person so if we go to a lien system
where only one person cares that person in their whole state there aren't the opportunities to lose information it's also around designing systems so that if there's been a mistake can we design it so that can't go wrong again
My name is Faye Bailey and I'm the acting director of nursing services at heart of England foundation trust we've always had systems and processes but now we're much more aware
of organizational learning when we find trends emerging through reporting of incidents we are much more systematic in a hospital environment in actually clearly identifying what the trend is and then putting the operational learning in to take away or minimize that error
My name is David Morgan I'm a consultant ENT surgeon I was the surgical advisor to the National Patient Safety Agency from 2000 to 2006 why I became focused on safety about 12 years ago when one of my patients was operated on by one of my juniors her and had the wrong operation that time I looked at the system and realized there are a lot of flaws in the way that patients are
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handled when they go through the
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surgical journey the consequence of that
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I went to see if we could use technology
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to improve the patient safety and
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actually improve their efficiency we
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developed a process involving a
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radiofrequency identity tag which came
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because of the dialogue I had with the
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IT director of Tesco supermarket who was
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using RFID in to stop any shoplifting
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and it struck me that it could be
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actually transferred into healthcare
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fairly easily and be used for safety
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proofing the surgical journey and by
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able to being able to measure the
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patient's journey you can actually
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increase theater efficiency and the
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result of that we found that not only
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does it mistake proof the surgical
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journey but actually improves theater
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throughput from anything from 19 to 25
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percent
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what games doing there now surely be
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going to talk about process management I
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mean process management is is known and
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implemented outside of healthcare but
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it's only just starting to make an
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impact on the healthcare by using the
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combination of lean techniques and
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process management coupled with new
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technology we can not only improve
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patient safety but also theater
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efficiency and efficiency throughout
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healthcare which is obviously better for
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the hospital but more important best for
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the patients I'm a consultant in the
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emergency department here and several
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years ago we realized there were certain
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processes here that gradually evolved
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rather than being designed from scratch
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and so we've actually added lots of
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extra little steps for good reason but
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actually when we stood back and looked
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at the whole system we realized there
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was a really complicated system for
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something that was relatively simple and
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getting rid of those weights didn't just
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reduce the waiting time it actually
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meant that staff who could spend more
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time with the patients because they were
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spending less time sorting out problems
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and more dealing with the patient
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directly one of the trends that we
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noticed through error reporting was an
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increase in drug errors taking place in
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the ward and we did an observational
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exercise looking at why that could
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possibly happen and one of the things we
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found was that the person who was giving
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the drugs out who was being constantly
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interrupted by doctors wanting
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information or other nurses wanting
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information or visitors asking for
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guidance other patients asking for
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guidance so became quite obvious during
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that observational exercise that it was
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no wonder errors were happening so what
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we did was think about is there any
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other examples in outside of NHS working
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that actually had the same problem and
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what we came up with was the airline
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industry they had introduced mechanics
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wearing red vests saying do not disturb
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me this I am doing an important task so
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we started we're getting out
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nurses who are doing drug administration
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rounds to wear red vests and what we're
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now seeing is a downward trend in drug
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administration errors
My name is Phil higden I'm formerly a British Airways pilot and I'm now director of training
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for terima what we do in Terina is to
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bring the safety processes from aviation
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into healthcare the processes are
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broadly similar with regard to the the
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people side the human factors aspects of
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crew resource management as it is in
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aviation team resource management as it
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is in healthcare are identical that
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you're just dealing with the fact that
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human performance is variable you're
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dealing with the fact that humans have
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to interact with one another to get a
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decent result and humans have to
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interact with systems and processes that
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if we can manage that fail ability if we
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have the skills to match that fail
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ability and we have the will to manage
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that fail ability then we can get a much
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more effective team we can get a much
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more effective result at the end of the
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day to beat up on the healthcare
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workforce or blame them for things gone
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wrong is naive and absolutely wrong
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to redesign healthcare so it can perform
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for patients the way we really wanted to
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that's mature that's advanced that's
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with you the healthcare needs to go and
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that's what works CSI is trying to learn
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with the rest of us we're still at early
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days we're running courses already where
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there's lots of Health Service managers
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and clinicians already starting to adopt
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it throughout the UK but we need to do
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more research in the area to work out
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which bits we adopt from other sectors
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and which bits the Health Service is
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slightly different
