SMART Wheelchair & Seating Kaizen November 2008

1. SMART Wheelchair & Seating Kaizen November 2008

2. Objectives • To identify areas for process improvement • To Improve patient experience • Reduce waiting times • Improve access • Improve equipment options

3. Approach • Protected time • Cross-service representation • Process mapping pre-event • Day one - extensive workout • Identify issues using 3 process maps • Group into common themes • Identify potential solutions • Prioritise solutions

4. Days 2 – 4: ‘try storming’ • ‘5S’ in 4 store areas • Sort, Set in order, Shine, Standardise, Sustain • Final Day - Action plan

5. Action Plan • 28 actions identified • Admin procedures • Patient pathway • Improved use of ReTIS • Stores • Many actions completed within the week

6. Administration Procedures • Streamlined referral process: • Goal: Shorter referral – assessment period • Issues: • Incomplete referrals • Separate referrals for each service • Adult Wheelchair • Children’s Wheelchair & Seating • Adult Seating • Person dependent

7. Actions • Referral Group • Number of different referral forms reduced • Creation of email address • Access to SCI Gateway

8. Results • SMART Referral form • Single point of contact • Reduction in incomplete referrals • Reduction in printing

9. Patient Pathway • Creation of combined adult and children power chair clinic • Children: • Maximum wait reduced from 11-4 weeks • Adult: • Maximum wait reduced from 8-5 weeks

10. Patient Pathway • One-stop adult clinic re-established due to modernisation funding • Chair storage facilitated through 5S • Many patients attending clinic are receiving a chair at clinic • Adult 42% • Children 20%

11. Improved Use of ReTIS • ReTIS ‘wish list’ • Standardisation of ReTIS use across services • Adaptations to ReTIS (new job types, screen appearances etc) • Staff refresher training • More joined up working

12. Improved Use of ReTIS • Accurate data entry of wheelchair stock: • Chair locations and status in ReTIS ‘untrustworthy’ • Large data cleansing exercise • New store locations created in ReTIS • Reduced stock errors • Quicker patient provision

13. Improved Use of ReTIS • Still ‘to do’ list • ReTIS to be available at point of wheelchair receipt (remote store) • Quicker stock availability • Provision of networked laptops for domiciliary visits • More efficient use of staff time

14. Stores • 5S in all SMART stores: • SMART wheelchair (children’s) • SMART wheelchair (adult) • SMART main component store • Livingston main store • Removal of obsolete / excess equipment

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19. After

20. Before

21. After

22. Livingston – Main Wheelchair Store • £15K investment in improvements

23. Overall Summary • Improved referral to assessment process • Combined children and adult power chair clinic • Re-establishment of one-stop clinic • Integrated processes across services • Enhanced team work

24. Benefits yet to be realised • Shorter waiting times with: • Staff recruitment / training • Release of modernisation funds

25. All SMART staff • ReTIS team • Lean In Lothian team • NHS Lothian • Edinburgh CHP