HSCDD

The lean philosophy starts with recognizing and eliminating waste in order to give value to the patient (IHI, 2005). The success of lean operation lies on the concept of value. Value is defined from the point of patients, department (staff and volunteers), management (HCSDD administration), community, and government. In this way, the process is basically driven by what patients want and HCSDD project take the right step to define which activities are considered to be ‘value-adding’ and the ones that are not. Experts say that Lean increases patient safety by eliminating errors, increases patient satisfaction, reduces cost and improves patient health outcomes ((Shivaji & Subramanian, 2009). However, the same experts agree that our health care system is riddled with excessive administrative expenses, inefficiencies, poor management, inflated prices, waste and fraud, and inappropriate care (NCHC, 2008). This concern has focused attention on Lean on efficient process and cost-effective healthcare management practices during our HCSDD program considering;Waste minimization:• HCSDD will use a master or central location for supply, with on-site reserves in the mobile clinics to manage inventory under the project and eliminate non-value-added activities and ensure cost reduction (Shivaji & Subramanian, 2009).• Use of test kits, devices, drugs and other materials will be monitored to avoid duplication, needless use and to effectively minimize waste of materials and reduce cost.• The Kanban process may be used – system of filling and keeping filled concept with the suppliers being tied up in the manufacturing unit itself and supplying the materials needed to the project location on time to time. This is also called just in time (JIT) and it’s aimed to minimize waste.People involvement: • Human interactions need to be understood in defining the value of the process for which the HCSDD program has been initiated. • Physicians, nurses, and administrative staff, and volunteers will assist in managing patient communication, interaction and emotions during HCSDD.• Each department (admin, operations & logistics, IT, Training, etc.) has to understand the value they desire to create for the patients during HCSDD. • Coordination with all the departments to understand their total process maps and integrate their processes with the total map of HCSDD is vital for effective patient care. • Global optimization is key in this project and so every stakeholder must develop an integrated view of the HSCDC values (Shivaji & Subramanian, 2009). Value integration demands commitment, time, and cost from all the departments and brings out in unity the objective of the HCSDD project.Continuous Improvement: The HCSDD will focus on continuous improvement hinged upon simplification, and cost reduction in;• Documentation and management of data, screening processes, testing and treatment, use of materials and other resources including manpower. • Quick emergency response among patients with critical diabetic conditions will be prioritized. We will have stock of rare medicines and stock of things for any emergency case issues. It is important for the program to serve the patient immediately.• To reduce the waiting time of the patients and provide them with timely information and service. • the initial and regular training of key workforce and volunteers to identify processes that would be analyzed with a view to reduce processing times and to improve patient satisfaction. Using tools like the A3 form. A3 is a document circulated to stakeholders to write and identify the current issues of the project with the objective of time reduction to customers. It also brings out the background information about the program with its current condition and status.• Use the Kaizen approach to take care of patients without disrupting the program ((Shivaji & Subramanian, 2009). HCSDD has to balance business with the human side of service and community benefit.Push vs. pull systems:The process of how the patients for screening will be reached, do we go to them or will they come to us? The same is applicable to how inventory materials such as drugs, test devices, etc., will be distributed. Often, the main difference between push and pull is seen as the difference between having a central logistic plan or information directly from the patient. If there is a central logistic plan, it is supposedly push. If the orders come directly from the customer, it is supposedly pull. Our logistic plan will be central depending on the customer demands and the lead time, the logistics department starts make-to-stock or make-to-order for the program (AllAboutLean.com, 2015). We will also use an Enterprise Resource Planning (ERP) system – business process management software that allows an organization to use a system of integrated applications to manage the business and automate many back-office functions related to technology, services and human resources, in which case the logistic plan would create its orders based on Kanban. Hence, when there is demand for tests either by us or firm the patient we will respond. Set up reduction:Setup time is the amount of time taken to change over a piece of equipment from the last piece of a production lot to the first good piece of the next production lot (Jba Consulting, n.d.). In the HCSDD program, from the patient leaving a step in their process to the next patient entering that step. Our typical set up will require • to Install/remove medical test equipment, position equipment, and use tools, • transport necessary materials for the Screening and tests, such as surgical equipment, thermometers, etc. While setup activity types will include;• Internal activities – all activities which must be performed while the test equipment is not running or physical examination is ongoing.• External activities – all activities that can be performed while the machine/ process is in operation. These includes getting supplies ready, patients organized, etc., i.e. while the first patient us examined or tested, the other is ready for changeover to begin as soon as the space is empty until the whole process is completed.Total productive maintenance:Total productive maintenance (TPM) is simply healthcare for equipment (ML&H, n.d). And it is not different from doing regular self-examinations and monitoring your diet to maintain your health and prevent sickness before it happens. We will encourage patient for regular checks though, while encouraging all staff to be responsible for equipment health while running test equipment, using screening devices, computers, mobile clinic trucks and project vehicles to reduce breakdown emergencies and cost. Cleaning and inspection will be prioritized during HCSDD set ups so that problems are detected earlier enough. Small problems, will eventually become big problems if unchecked and may lead to wrong diagnoses and may interrupt the HCSDD program.

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