Video | Engaging Health Care Staff to Create Better Processes for Patients

Virginia Mason Institute

Chris Backous, a Virginia Mason Institute Sensei who is facilitating 3P (Production Preparation Process) workshops in Iceland, describes how the health care team at Landspítali, the National University Hospital of Iceland, is thoughtfully designing the very best hospital they can imagine.


0:00-0:20 Chris Backous A 3P is a five-day process to look at where we are today, and where we need to go in the future. We feel at Virginia Mason and as part of a lean management philosophy that people who have the best answers for the future of our care are the people who provide that care today.
0:21-0:43 “3P” stands for production, preparation and process. It’s not about a top-down decision and a mathematical calculation of square footage and “this is what we have now, this is what we need in the future.” We actually look at what we do today, we make it better, and I always tell the teams “we don’t want better, we want insanely great at the end of the week.”
What do we produce in health care? We produce patient care, decisions, plans of care. What type of facility would best care for that group of patients? What type of equipment? How close does it need to be for them? So we really do a deep dive in every aspect. We call it “the flows of medicine,” so of course the first thing we look at is the flow of the patient. Why is the patient not flowing through our system today, and how can they get their care without wait or delay in the future? Then we look at the flow of our providers. Who is trying to provide care to our patients? What are their current burdens, and how can they work in a waste-free, value-added environment in the future?
1:26-1:57 Information is a very important flow, and when we’re designing new space we want to think about those spaces that limit our ability to communicate, whether it’s verbally or visually, or just being in a similar situation and absorbing the environment from one another so that we can help each other out. Many ideas are spoken, but very few ideas are acted upon. So if we can put something in the hands of people and have them actually build their idea, the person next to them can see what they’re building, and be inspired by what they’re building, and that thought to the idea.
We believe in “form follows function,” but to truly get a lean form, a lean design, we need leaner processes. And again, it goes back to the best lean engineers are the people who do the work. So if we can put Legos in their hands today, just imagine where they would tell the building construction teams to put the different care spaces. And that’s what we’re really trying to do is really engage the people so that the space that they walk into is the space that they’ve imagined, and they can begin that imagination now.

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