Lean-Led Design: How to Achieve Optimized Operations

Production, Preparation and Process to Improve Healthcare Operations

Lean-led design is a process that involves intense participation by all stakeholders within an organization and design team. For several days, the group engages in an interactive process called 3P—production preparation and process. For the New Valley Hospital, in Paramus, N.J., the 3P process enabled giant leaps forward in a short amount of time. 

The desired outcome is delivering an optimized future state. Operational solutions are developed by the multi-disciplinary group in a non-traditional manner by stakeholders who plan together through immersive workshops that cross a full timeline of current to future state.

This new style of group integration can improve operational efficiencies, identify and eliminate waste, create opportunities for innovation, and build consensus by ensuring that all stakeholders have skin in the game and a hand in influencing their own future and that of their patients.

A Holistic Perspective

The old way of planning went like this: Meet individually with departmental users, then program, plan and design each department. Interdepartmental collaboration doesn’t occur and operational silos are reinforced, stunting process improvement.

The new Lean-led Design approach restructures owner participation into an integrated, multi-disciplinary process in which teams are organized by how the hospital functions as a single entity.

For example, we don’t just meet with surgical staff. We organize a team of admins, physicians, nurses, aestheticians, technicians, maintenance and anyone else who participates in the surgical process from start to finish. This way, a complete picture of the process is examined. Each major patient procedure or touchpoint that occurs in the hospital is explored this same way, developing each one in coordination with operations of the entire hospital, not just within a siloed department.

Current State

To measure improvement you have to have a starting point. During the Current State workshop, that starting point is established by looking at existing operational flow of each service line. This is done by the multi-disciplinary stakeholder teams in an open forum so that all staff can identify the nuances of their processes together.

Many misperceptions of how the hospital is actually operating are revealed and the team is able to identify inefficiencies, bottlenecks and other obstacles that exist in the current state operations.

Future State

Once the current state is understood, the multidisciplinary team reassembles to create their optimal flow through their entire facility—their Future State.

Focusing on the obstacles and bottlenecks revealed in the Current State workshop, a group discussion to optimize operations collaborates to eliminate wasted efforts, resources and time. The same participants engage in this activity so that they are already familiar with the issues identified previously.

It is much easier to identify how to improve processes when you were part of the team that identified the problems. Often, it’s difficult to keep the team from identifying solutions up until that moment because the new ideas create an eagerness unmatched by other design processes.

A New Healthcare Vision

Once the current state is understood and the future state needs are established, we begin with a tabular space program informed by the future state flow maps and end with a preferred planning solution complete with quarter-scale models and large-scale room mockups.

All of this is accomplished by the multidisciplinary team ahead of design and design review.