Lean Organization Profile

Organization:  Vancouver Coastal Health
Location:  Vancouver, British Columbia
Focus:  Perioperative Services


It was a goal of Vancouver Coastal Health (VCH) leadership to focus on spreading Lean to their frontline staff.  One of their strategic initiatives for the year was to improve throughput in Perioperative Services.  Therefore, VCH chose to hold a reVIEW© course dedicated to the Operating Room operations and processes.

The Perioperative Services course was comprised of frontline OR nursing staff, OR supervisors and managers, pre-surgery nurses, and recovery room staff.   The course participants split into teams to address the following processes:
•    Hand-over of surgery patients from inpatient floors to pre-surgery
•    Set-up of OR suites
•    OR staff morning report
•    Pre-surgery to OR hand-over
•    OR suite turnover
•    Admission of patient into recover room

Utilizing value stream mapping, the teams discovered other opportunities for improvement such as delays associated with patient and staff flow.  As a result, the group used A3 Problem Solving to focus on the delays affecting throughput in the OR.   Outcomes of the A3 Problem Solving Projects included:
•    Create standard work and a checklist for inpatient units to use when sending a patient to surgery
•    Match capacity to demand for echocardiograms in pre-surgery
•    Standardize the morning report process and create visual management for staff assignments
•    Standardize OR nurse’s role in preparing the suite and retrieving a patient in pre-surgery
•    Implement use of Vocera devices to facilitate direct communication between staff
•    Specify Operating Room Assistant activities to be done immediately when patient brought into recovery room
•    Standardize cleaning processes for OR suite turnover

With this concentration on OR specific processes, the group was able to “dig deep” and make significant internal processes changes.   Their Lean journey carries on as this group continues to use A3 Problem Solving in their everyday work and coaches their peers in A3 Problem Solving.  The next step for the Periopartive Service department is to train internal instructors and cycle more staff through the reVIEW© program.  It is obvious that VCH and its Perioperative Services department are dedicated to spreading Lean to the frontline.