Wheelchair Repair Service

1. Wheelchair Repair Service John Colvin, WESTMARC

2. West of Scotland Mobility and Rehabilitation Service WESTMARC Serves 52% of the population of Scotland

3. West of Scotland Mobility and Rehabilitation Service WESTMARC

4. Westmarc Technical Services - YokerDepot Repairs 12,000 Refurbishments 2,600 Modifications 6,500 Deliveries 11,000 Collections 6,400 Total 38,500 120 homes per day

5. Improvements to Repair Service • Brought “in-house” April 2005 • Included better staff conditions • Reduced costs allowing internal investment • Increased vans to improve capacity • ReTIS introduced in Sept 05 • Van tracking introduced April 06 • Sept 06 to 08 improved technician training • 06/07 major refurbishment of Yoker site

7. Rapid Improvement Event defined Current State • Call Centre Waste: • Waiting: patients can’t get through; only office hours • Rework: double handling; callbacks; no protocols or diagnostics Production Control 2nd Visit Reason Data: • Pt not home 48%(pt cancels 7.5% • Wrong parts/chair/spec – 31% • Follow on repair 2.5 % • B.E.R 9% • Engineer no time 2.5% • No explan 3.5% • Call Centre (Admin • Check user name/dob/contact details • What’s wrong with w/c • Determine Priority (U.P, R) • Raise Job Sheet • Identify chair ID number • Initial scheduling (next available slot) • Give date to user If eng finds reqt for further repair – NEW Job sheet! • Pt records • W/C records • Scheduling post code Order = w/c faulty Customers START Promise = engineer visit date Patient (phone) First time Fix Data %jobs fixed first time = 74% Steve Gray • Repair • Other Clinician job sheet/fax, letter 5 mins DP = Thursday Can’t complete repair - Update reason on job sheet • Return job Sheet (Admin) • Update RETIS/special circumstances • Phone/letter to Patient • Job on hold • Back to scheduling RETIS RETIS • Van routing 8 schedules. Cannot see all areas in one go. Schools a hassle • Cannot do all areas every week • Don’t schedule: • outlying areas • Holidays • VAN RUNS PLANS Health Boards Consortium • Move work: • 2nd visits • Non-scheduled work • Deliveries Noon, weds • H2 ID Parts? -> picking accuracy Patient does not respond/ not there -> leave card… What time do you actually get mobile? 8.30/9am Thu Customer • Work out Part numbers - RETIS • - Check stock available • Engineer • Collect trolley each morning • Some-check trolley -> tale problems to the stores • Plan route am/pm Admin -Take AM/PM plan from engineer - Some patients call in Collect deliveries Mobile Target 9.30 • Arrive Pt • Inspect chair • Check got right parts/what’s wrong • Do repair Return Job Sheet Return unused Parts -> Stores -> back into stock Schedule Job to Technician (Call centre) Admin phone Pts. Added in by coordinator • Got Stock: • Pick • Update job sheet • Bag (copy Job sheet) • MARSMAC -trolley Detailed Scheduling 1. Add more work 2.Chg schedule for geography or eng disability - Print Job Sheet - ID Parts req’d - Pass for stores • Complete Repair • Fill in job sheet • Pt signed time Patient Repair Response time Type Target % Urgent - 1 day 33% Priority 3 days 53% Routine 5 days 69% • Some salvage is inappropriate • Not clean • Not safe/Q • Waiting • If capacity not clear on schedule cannot easily ‘shoehorn’ in Admin Close job on RETIS -> data entry Demand Analysis: 12 mth sample No Urgent Jobs : 4% - 496 No Priority Jobs 12% - 1610 No Routine Jobs : 84% - 11282 Total no Jobs: 13388 • Stores: remove part for salvage (ownership unclear): sometimes workshop +1 day, don’t know • Coordination 8 scheduling Waste • Waiting – 2 days delay built into process Order authorised… No order confirmation… • Stock Mgt • Obsolescence • Disposing of chairs Parts come in – JOB Done! Parts have been salvaged…. Sometimes booked into stock without reference to patient order END Don’t have times in system RETIS Stores Data No Picklists per day: 16 No parts/per day: 50-75 Cycle time/picklist: ~20mins No. staff (repair picking): 3 1 driver ~ 10 jobs per day • Waiting • If engineer is sick whole zone shut • If job incomplete paperwork waits one day An average Day - 61 repair Jobs - 3 urgent - 7 priority - 51 routine - 4 jobs per day for 14 engineers Admin: Match delivery Note -> PO Supplies: Authorise Payment • - Check Part number (RETIS) ->manuals/CVS net • Rolling stock • Non standard stores • Stores -> move job to scheduling • Van schedule • (Coordinator) • Not Got Stock: • - Salvage • - Source Central Purchasing Dept -> Move to another System -> PECOS? CEDAR -> fax to supplier Supplies dept GRI Yoker expedite Book in stores -> flag up Patient Job sheet - Get quote from supplier (if non-standard) - Place Order (RETIS) 6. Supplier Leadtime • - Processing • Confusion of roles • Who owns checking of vans etc • Time spent coordinating • Always catch up Stores -Motion: Location of manuals, fax, m/c Processing: over picking, multiple job sheets, patient parts ‘straight to store’ Inventory: runners out of stock No info on stock outs Stock Data No Salvage Jobs: avg 5-7 per day No stock outs: avg 12-15 per day Slow moving stock --- • Stores: Waste • -Waiting: pick lists wait one day • Waiting: part ID delays, no parts, try to salvage – delay, supplier response times • Waiting: delay to quality check, delay driver returning parts, delays chair return Supplier lead time data – contract 0-2 days – 4 3-5 days – 6 6-10 days – 10 >10 days - 7 No contract time - 3 • -Rework • Coordinators 8 drivers checking over double work? • Repeat jobs – why? Supplier/Parts Order Data 4867 part nos on shelf No Stocked parts 1962 No non-stocked parts ~5000 No supplier contracts ~29 2 parts nos in system 7106 • Transportation • Return to base to retock • Hard to see if van in ‘resion??’ for filler

8. (Production Control) Call Centre Manual Chairs/Uni • Check part details • Create job sheet • Check chair configuration • Fault diagnosis • ID parts required and part nos • Check and allocate stock • Confirm Engineer available • Agree appointment/ Urgent Routine Training Matrix RETIS F M J A • Accurate Data • Patient record • Chair details and config • Stock records Other Chairs - check part details - Create job sheet - Check chair config - Fault diagnosis • Opening hours – Patient Access • Demand for extended hours will be understood [V.O.C. analysis] • Performance Targets • 1. Repair response time • URGENT = 1 DAY = 75% achieved • ROUTINE = 5 DAY = 90% achieved • 2. First time fix • TARGET = 90% • Ways of working • 1. Measure our business and share with staff • - daily team reviews (short/sharp) • - monthly team meetings • 2, Team Leader role • - Train staff • - coach people to continuously improve performance • 3. Personal accountability Order = w/c faulty Customers Better phone system -> patient can wait & queue Patient (phone) Clinician (advocate) Response Promise URGENT ROUTINE Job owned by coordinator Parts id; allocate; schedule UNI Call centre Manual Call centre trained on product range, repairs and part numbers GPS SYSTEM ON Update calls during the day Training Matrix Suppliers Engineers Supported by: • Product training • Better tooling • Better VAN STOCK • Parts for urgent repairs - castors - wheels - brakes - Better comms with Admin F J A Manual URGENT – SAME DAY CUSTOMER • Allocate to driver via GPS txt • Fix via van stocks • Or ID parts reqd …OR Refurb engineer takes job from depot • Complete repair • Patient signs job sheet • Engineer texts admin Admin • Can’t fix\ • Assist Pt as far as can • ID parts reqd • Text Admin  pick parts\\ 1 day target applies regardless of zone URGENT – NEXT DAY CUSTOMER Van Schedule 8:30am Pick Parts 8:45am Collect Parts Mobile 9:30am • Complete Repair • Patient signs • Engineer texts admin Better capacity planning! CUSTOMER ROUTINE capacity demand Van Schedule Day 1 Pick Parts Day 2 Collect Parts Day 3 Do preventive maintenance [schedule to be agreed] • Complete Repair • Patient signs • Engineer texts admin Identify part no Check stock Preventative maintenance formalised Maximum 5 days: better if capacity not got got STORES PARTS PLANNING PROCESS  Confidence we have the parts… Allocate Confirm delivery date expedite 20% 80% K K K K K Better stock system Training Matrix F J A Training for stores staff 100% stock accuracy Major suppliers on KANBAN FAST MOVERS RIE defined Next Future State (within 6 months)

9. The 6 month Action Plan • Redefine job prioritisation • Write a repair script for admin staff • Call recording and appraisal of call handling • Improve communications with van guys • Introduce Kanban systems for stock control of parts • Redesign purchasing processes (remove Supplies Dept.) • Redefine van stock (essential rather than common items) • Stock Controller – (new role to define what part is needed) • Changes to ReTIS mainly to support stock management • Introduce Communication Cells • Improved supervisor training for performance management

13. What was going wrong? • Team coordinators did not believe in the data used in the Communication Cells or the Pareto analysis of causes of delayed repairs • Calls that could not be programmed within target were not always highlighted to coordinators. • There were more van zones than vans • Batching increases WIP and decreases efficiency • Reducing zones was counterintuitive to all mobile engineers and coordinators

17. Issues we still need to tackle • Is Urgent/Routine defined properly? • Closing weekends and bank holidays disrupts work flow. • No out of hours emergency cover. • Do our targets need to be revised? • Repairs to seating are currently slower • Getting access to the wheelchair.