Case study review assignment on the topic titled “Lean Process Improvement at Cleveland Clinic”

By-Tarun Arora (MBA-Healthcare Management)

Roll Number-1920983084

Q1- Examine and write how Cleveland Clinic applied the principles of Lean (Lean Principles) to
improve the process of surgical instruments in surgical processing department?

Ans1-The objective of the case should be focused on the principle of lean at Cleveland case solution.
This analysis can be proceeded in a step-by-step procedure to ensure that effective solutions are found-

In the surgical processing department following factors are taken into account majorly-

A) Redesigned material flow

B) Balanced Job Duties

C) Moved Bar Code Station

D) Moved Racks to match flow

E) Implemented visual control for material path

Inference-

A) Repositioned drier cabinet that is done because to reduce the degree of contamination to some
extent or to reduce the physical contact which will also helpful in reducing the rate of infection to some
extent.

B) Initiated work orders for two safety issues that is the safety of the person handling the process of
decontamination followed by the infection control measures to be taken care off while doing any
incision whether it is any major or minor surgery which includes risk such as surgical site infection.

C) Eliminated unneeded equipment and racks that is because for the smooth flow of the persons who
need to move here and there rapidly while assisting in any major or minor surgery which will also in
improving the procedure outcome to some extent.

D) It is only because of uninterrupted supply of equipments which reduces the procedure time to some
extent and results in the effective in effective clinical outcome.

E) Implementation of artificial intelligence can give rise to the new field of medicine which is precision
medicine that is controlled use of drugs, proper temperature maintainance or results in the generation
of new kind of treatment that is minimal accessive surgery, reduces the work load of paramedical staff
to some extent and a valuable asset for the organisation to expand its reach to other countries.

Q2- Identify the improvements that were made at each step of processing surgical instruments in the
surgical processing department.

1
Ans2- There are a lot of improvements that were made at each step of processing surgical instruments
in the surgical processing department that includes overproduction, rejects/rework, excess inventory,
unnecessary motion and transport etc.

In detail, this can be improved as follows that is-

1) The controlled supply of drugs that is correct dosage plan should be formed in which the correct
number of entities should be mention which prevents the problem of over dosage.

2) Rejects /Rework policy which should be formulated by the Performance and Service improvement
team by using various strategies such as-Six Sigma, Lean ,PDCA,FMEA etc that is the various parameters
should be taken care off that is the expiry of any drug, clinical auditing, timely compliance record should
be maintained which helps in effective diagnosis and treatment of the patient.

3) Excessive stock of material should be avoided because various factors to be taken care off such as
expiry date, temperature requirement etc that is efficacy of the drugs should be reduced.

4) Walking time should be reduced that is because of corrective positioning of instruments, equipments
as per the requirement of the surgeon.

5) An improved workflow was established and standard work was created that also results in improving
the brand value because of increase in successive rate of surgeries.

6) Degree of sterilization was improved that also helps in improving the infection control rate to some
extent.

Q3- Find how Cleveland Clinic applied the principles of Lean to other processes in the hospital?

Ans3- The Cleveland Clinic applied the principles of Lean to other processes in the hospital such as-In
MRI, Reducing the variance to standard for hospital stays this can be done as follows-

1) Magnetic Resonance Imaging Efficiency- A) The Lean Improvement was implemented to assess the
need for contrast and start the intraveneous line (if required at the beginning of the MRI procedure.
there by not interrupting the Scan process.

B) It also identifies the opportunities to better to better utilize existing equipment and off-site locations
to schedule and serve patients.

 Outcome-All these efforts combined resulted in an overall decrease of the MRI procedure lead
time from a baseline of 21 days to a new average of 11.5 days. In addition, there was a year-to-
year increase of 1,560 completed exams i.e. 4.7 % between 2008 and 2009.

2) Reducing the variance to standard for Hospital Stays- A) The Lean Management Project was
implemented to reduce the lead times for the processes such as Lab diagnosis, Checkup by nurse who
determines the number of tests required to be done etc .

B) Matrix Method was come into existence to count the exact number of tests to be done followed by
making a checklist for everything.

 Outcome- By implementing Lean Management the hospital was successful in reducing the
waiting time of the patient and helps in reducing the problem of overcharging to the patient

2
 which is therefore helpful in gaining the trust of the patient and will be helpful in increasing the
overall sales of the hospital by word of mouth and attaining the satisfactory place in the market.