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Learning to be proactive - with Lego

12/11/2014  -  created by Ingo Kwoka  -  Categories Process management

A few weeks ago, the Friederikenstift foundation in Hanover contracted us to introduce lean processes in their hospital, in cooperation with an internal steering committee. Ahead of the process analysis phase, we conducted introductory talks on the subject as well as training sessions for the steering committee and managers. Here you can read the article the steering committee wrote for the in-house staff magazine. It was written because transparent communication is a top priority for our client and key to successful change in its corporate culture.

More process orientation in the hospital

Thomas Plagemann and Dr. Frank Weidemann dash back and forward between the tables in the conference room. There's a card with a picture of a euro-pallet on Matron Elke Reinfeld's table. After just a few seconds, Reinfeld has built five "roof elements" out of Lego bricks and called on the "logistics department" consisting of Plagemann and Dr. Weidemann to transport the parts to the next station. There, Birgit Löhmann is putting together more bricks and sending the parts on to Mathias Winkelhake. The half-finished roof elements are piling up on the managing director's table. He can barely keep up with production because he has to carry out more assembly steps than any of the others. Meanwhile, Prof. Dr. André Gottschalk is sitting around doing nothing. He's responsible for final assembly and is still waiting for the intermediate products.

Why are the four DKF managers spending a Friday afternoon in the conference room building roof elements out of Lego? They are participating in a workshop organised by the initiative ProAktiv - The Process-Oriented Hospital. The program is designed to continually and systematically improve work processes in the DKF with the goal of increasing patient satisfaction and the employee work situation.

Also included in the workshop is the practical simulation of a collaborative work process. "The easiest way to do this is with Lego bricks" explains Ingo Kwoka, a consultant from SYNCRO EXPERTS who is in charge of the workshop. At the end of the first simulation round, there isn't a single finished roof structure in the delivery warehouse. Ingo Kwoka plays the role of the boss of the roof element company and says sternly: "Now our customer is really annoyed". The DKF managers look away guiltily.

Then everybody discusses how the production process can be improved. Kwoka supports them with well-directed questions. The participants learn that it's not always the most obvious changes that improve results. What really helps are many small improvements and the application of process management methods and principles. Process management has been successfully applied in industrial companies with lean management concepts for decades to improve customer orientation.

And that's a relevant aspect in hospitals as well. A patient survey by the health insurer Techniker Krankenkasse revealed that patients are highly critical of waiting times during in-patient stays in the DKF. The employee survey highlighted the problem of a heavy workload. These are areas the ProAktiv initiative is set to tackle. The goals are increasing process quality from the patient viewpoint, reducing in-patient times and cutting back workloads and overtime.

"We want to free up our employees from activities that don't contribute to patient treatment and care. These are in particular tasks such as searching for things, waiting, asking for information, remedying mistakes, redundant work, avoidable transfers", explains Christoph Lammers. He stresses what's important: "Increasing workload and doing more overtime is exactly what this isn't about. With the ProAktiv initiative we want to achieve the opposite - despite a tight budget".

The process improvements are worked out in "improvement workshops". These are interdisciplinary and made up of 4-8 employees. The employees are experts in their fields and during the workshop they independently draw up improvement measures. Workshop moderators provide support. Apart from the external consultants in Ingo Kwoka's team, this consists of an internal core team made up of Carina Müller (coordinator), Dr. Sabine Pape, Dr. Frank Weidemann, Thomas Plagemann and Christoph Lammers. The first improvement workshop has already started work.

Meanwhile, the fifth round of Lego roof element production is under way. The group has improved the production process strictly according to process-oriented methods. After 4 minutes, all 18 parts are finished. That’s a record. "It's amazing how much the work process improved after very simple sequence changes" says Birgit Löhmann. The task in future is to apply these approaches in the hospital. And to pro-actively find new solutions for old problems.

Christoph Lammers, CFO, Authorised Representative, Diakoniekrankenhaus Friederikenstift gGmbH