The division of duties between Gertie Brepoels and lean practitioner Bianca Wauben certainly bore fruit! They complement each other well, are able to motivate employees to make processes clear and transparent, and their successful projects serve as a catalyst for change.
The first major project within the Dialysis department was conducted in 2014 and focused on scheduling. At the time, it had become clear that the work processes were ripe for change. Something needed to happen, but what?
The project had tense beginnings. A new department head, a new lean method, and high expectations all prompted resistance to change, as is often the case. Thankfully, right from the word go, we had six enthusiastic employees who were happy to cooperate. The red Post-it notes that highlighted existing bottlenecks during the analysis phase gave everyone a clear signal that our gut feeling was right: it was time for change. Gradually, we got the whole department involved, the dialysis nurses presented the new working method to their colleagues themselves and plenty of opportunity for feedback was given.
The new schedule resulted in a redesign of the division of duties to benefit everybody, especially patients! We still review the schedule regularly and make adjustments every now and then. The project helped to implement change in the department and get the employees involved.
"You try to optimize the process wherever possible, and in this case, it also freed up more time for indirect patient-related duties.”
To get started with home dialysis, patients must complete an extensive preparation process. A full year could often elapse between registration and the start of home dialysis. To try and shorten this period, we set up a project team consisting of two dialysis nurses, two home-dialysis nurses, doctors, social workers, and the supplier of the home-dialysis equipment. Until then, the process was largely the responsibility of a single person, but the implementation of this lean process spread the duties among multiple parties. The first practical results were encouraging. 'This project really made a difference, and I'm proud of what we achieved,' said Gertie Brepoels.
Culture and future
We frequently work with the A3, regularly evaluate our projects, and are constantly optimizing. We've completely adapted to working this way: it's almost automatic. The employees are inspired by the success of the projects and even contribute new ideas and projects themselves. We strive to set up new projects using the lean method. At first, we were tempted to jump straight to the solution. We've all had to learn that it's vital to conduct thorough analysis first to identify the problems and their causes. In short, you have to find out the exact root of the problem before starting to devise solutions. By doing this together with nurses, doctors, managers, and support staff, it is truly a joint effort by the entire department.
"It frees up energy and creates expectations. If you don't do it right, it can really disappoint the participants, but if you can harness that energy, you can go a long way together."
The fresh perspective of new employees is also greatly appreciated. They take the Yellow Belt training course and are asked to carry out an A3 improvement project. We have had numerous positive responses to the course. People have commented that it's a really great way to work.
At the Dialysis department, we've learned to work together very effectively. Nowadays, we're increasingly tackling cross-disciplinary processes, such as how to optimize the care chain that we are part of. It's really useful to work together with other departments, as it allows us to optimize processes using the same hospital-wide methods
We have noticed that when multiple departments are involved, the process can become more complex and take longer. In such cases, the enthusiasm and experience of the managers involved is vital. The more complex the projects get, the more important it is to trust the employees and give them the freedom to devise their own solutions. Our experience with this method is that employees take greater responsibility for their processes and we really see them flourish as professionals.
Home dialysis: dialysis within the home environmentPassengers Department of DialysisJourney
In the future, more and more dialysis procedures will be conducted at the patients' homes. At first, the preparation process was suboptimal, causing stagnation of inflow and outflow. The project has reduced the throughput time and allows patients to start dialysis at home much sooner. Continuity has also been improved as in the initial phase, the patients are trained in conducting home dialysis by the primary nurse, who serves as a fixed point of contact for the patient.
Dialysis: individual shunt reportsPassengers Department of DialysisJourney
During dialysis, it is vital to gain proper access to the bloodstream. Every shunt is unique, and individual guidelines are vitally important when administering the injection. Now, all dialysis patients with a shunt receive a tailor-made handbook consisting of a drawing and a photo of the shunt. This information is documented in the patient file and gives the nurse useful information when injecting the shunt.
Primary nurse: every dialysis patient is assigned a fixed nurse who serves as their primary point of contact.Passengers Department of DialysisJourney
Every dialysis patient is now assigned a fixed nurse who serves as their primary point of contact. In the past, this role was fulfilled in a variety of ways. After examining the entire process together with all parties involved, we were able to formulate a straightforward description of duties and coordinate the patients' dialysis schedules with the nurses' shifts.