NHS

Fedden USP Ltd are working with one of the most innovative NHS Trusts in the country and one of the few to be rated as ‘excellent’ for its quality of services and its use of resources. It employs over 5,000 people and is one of the biggest employers in the region.

The Trust is constantly looking at ways of improving its processes so that it can exceed its targets and continually improve the level of service it provides.
As with most hospital Trusts, it is a large and complicated organisation and change has to be managed carefully, with minimum disruption to service levels.

Workshop Objectives

Neil Fedden has run several workshops for the Trust. These covered Workplace Organisation within the Finance Department, Process Improvement within the HR Department (regarding recruitment) and finally a review of its processes for running improvement projects.

The aim of all the workshops was to involve members of staff in looking at ways of simplifying these processes; eliminating wasted time and effort so that they could more effectively deal with the demand on resources.

The staff were shown how to use improvement tools and techniques on a daily basis, so as to create a culture of staff-led continuous improvement.

Workshop Format

Each 4-day workshop ran over a period of two months and was attended by 8 to 15 members of staff. To begin with, the workshops introduced Lean and Process Improvement and explained the theory behind their application to transactional processes.

Next, processes were mapped in detail to identify and eliminate information waste. Examples of information waste found in all transactional processes within in any sector are:

• Bottleneck departments
• Lots of validation checks – multiple signatures
• Multiple uncontrolled documents in circulation
• Batching of documents
• High levels of data re-entry and re-keying
• Production of reports that nobody uses
• Fast track routes that slow-up everything else
• Personal filing systems
• Unpredictable processing lead-times

By involving staff from different functions within the process, and wherever possible internal customers, everyone gets an understanding of what each other’s role is and the kind of problems they encounter.

Having identified the information waste, the team used a technique known as ‘Rich Pictures’ to map out a future state of what an improved process could look like. This helps to eliminate the waste and simplify the process.

The team agrees the new process together, which ensures the maximum amount of buy-in before making the changes, thus reducing potential resistance to change to a minimum. Involving large numbers of staff helps in communicating the changes and their benefits to other people within the department.

Finally, the team agreed an action plan with timescales and project owners to take the process from its current state to the desired future state. This action plan was placed on a Policy Deployment Matrix, which is a visual way of linking improvement activities to the overall strategy of the business. This helps in prioritising improvements and ensuring that the projects are allocated enough resources to make them a success.

Long-term Sustainability

The workshops were followed by Mentoring Days to help the project owners implement their actions and overcome any barriers.

Wherever possible Key Performance Indicators (KPIs) are identified to ensure that improvement projects generate real tangible benefits, which do not drop off once the initial enthusiasm wears off.

Linked into the KPIs are Problem Resolution Charts onto which any member of staff can log problems. In weekly meetings these problems are discussed and solutions are identified, along with any corrective action required to keep the KPIs on track.