Home' AME : AME Target Spring 2015 Contents the other leaders — one director does
procurement and the other distribution,”
Beach said. “With high-level advocates,
momentum kicked in.
“I co-led the delivery system design with
nursing that was foundational to the way
we designed our new building. We knew
what we had and we knew when we
first brought the concept that it would
be beneficial with our current general
medical supplies, like labs. There were
many opportunities — the model could
be applied anywhere. For a scientist,
for example, that meant we could apply
the model and allow the scientist to go
back to the bench.” (See “Supply Chain
Professionals Doing 4P Design Work.”)
Beach and his team did not come totally
unprepared into this transformation.
“Sure, we learned on the job, but then
we went over to Toyota in Japan, and we
stole shamelessly. We looked at how the
Toyota staff worked and moved. We no-
ticed that things were brought to them —
it was real-time and predictable. We saw
nurses and clinicians as assemblers, so
we knew we had to minimize travel based
on the Toyota principles,” he said.
As for the other end of the supply chain
— logistics — the team brought in the
University of Michigan Tauber Insti-
tute for Global Operations to teach its
leaders the basics of lean supply chain.
This effort was foundational for the jour-
ney. Prior to the Tauber group arriving,
concepts such as “lead time” and “fill
rate” were foreign concepts for the team
according to Beach.
“We focused solely on warehouse
inventory turns but this did not give us
any insight on whether the nurse had the
supplies at the bedside in time or in the
right quantity, Beach said. “We really had
to think about how to apply manufactur-
ing concepts to health care. And that’s
when it all started expanding; we had
focused initially on things we distributed,
but then we moved to other supplies,
so we were able to cut back on search
time,” Beach said.
Extending the Toyota Production System
to the bedside for patient care was a
breakthrough. The team found a way to
take it one step beyond delivery to the
nursing units, with supplies being sent
via a two-bin system into patient rooms.
Starting in April 2013, a rounding cart
began twice daily in-room replenishment
of the most common patient supplies
— s aline solution, for example — in
bins, as indicated on a card tracking the
highest usage products. Instituting this
bin system with the new building allowed
Seattle Children’s to reduce search travel
time of nurses by 50 percent.
“We have more people in our depart-
ment, but we haven’t added staff,” said
Beach. “In the laboratory, for instance,
we took on some of their work and
found that while they needed five people
to do supply management, we could do
it with 0.5 FTE . So when we took over
their supply management work, we took
some of their people because standard
work for us was more efficient.”
© Patricia E. Moody 2015.
SUPPLY CHAIN PROFESSIONALS
DOING 4P DESIGN WORK
Seattle Children’s Hospital dipped into the
breakthrough design approach with 3P. For
over a year, Greg Beach, senior director of
supply chain at Seattle Children’s Hospital,
and his team participated in 3P design with
nursing and facilities to develop a better nurs-
ing unit and patient room design.
“We mocked up in cardboard in greater detail
with the architects the exact dimensions,
and 4P helped us address the fine details —
light switches, gas outlets on the walls, for
example. We had more than a year of planning
and mockups before we handed it over to the
architects. I know it helped reduce building
size by 30 percent,” he said.
To answer, “Can the nurse get what she
needs?” the team reviewed the details — the
bottlenecks, the flow of supplies coming in
this way, with the patient moving this way, etc.
“3P is a different approach. It’s pretty impressive
when you get everybody going over the design,
touching and seeing, moving from a cardboard
mockup to finished site,” Beach said.
(For 3P/4P examples illustrating
pre-production design work, see
The Perfect Engine: How to Win
in the New Demand Economy
by Building to Order With
Fewer Resources, by Anand
Sharma and Patricia E. Moody,
Simon and Schuster 2001.)
When the cardboard mockups were complete,
the team next moved to a real-time pilot in the
warehouse, evaluating all material and workflows.
None of these projects would have gone
forward, however, without good working rela-
tionships between clinical staff and the supply
management logistics pros.
“I have a political sense about me,” said Beach.
“There’s lots of learning and lots of fun if you don’t
ruffle feathers. The nurses in our area like us. We
are a magnet hospital and that means it’s import-
ant for us to be integrated into the clinical depart-
ments because we know that supply management
and logistics are key to a better system.”
SPRING 2015 TARGET 39
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