HOP Lachine - workshops

Modernizing a hospital is a golden opportunity to rethink and reorganize how care services are provided. Before developing plans, it is important to consider ways of improving work organization to provide better service to patients and families. This is what Lean Design workshops allow us to do. In other words, these workshops provide an opportunity to envision how to put patients and their families at the heart of care processes and improve their experience.

Patient partners have actively and systematically participated in the workshops. By integrating them with the teams, they collaborated with the other participants (employees, clinical and administrative management of the hospital, and the planning and coordination teams) to define the functional plan for the Lachine Hospital - a Hospital Oriented towards Patients!

Defining the project’s vision and guiding principles

Objectives

Participants were invited to imagine the Lachine Hospital of 2020. They then had a roundtable discussion and focused on the consensual elements about each of the five themes included in the project’s vision:

1. The patient experience
2. Health care and best practices
3. The environment and support services
4. Our employees
5. Our hospital in the community

In addition to the workshops, a consultation on the future of the hospital was conducted with 255 people, including patients, staff, physicians and residents of Lachine. Workshop 1 and the consultation made it possible to define the five guiding principles of the project.

Result

The guiding principles will form the basis of subsequent workshops.

Stats

• 42 participants
• 15 topics explored
• 30 hours of brainstorming
• 2862 generated ideas

What participants said

• Stimulating and interactive; interesting newspaper article concept.
• Exchange of ideas with people from different backgrounds; we all have similar priorities.
• Very good preparation, dynamic team, great time management.

 

Documenting current and future patient flows.

Objectives

Using 2D and 3D models, participants mapped five patient care trajectories: bariatrics, diabetes, cataracts, geriatrics, and chronic obstructive pulmonary disease (COPD).

They then analyzed the current issues and identified opportunities for improvement. Finally, they mapped out an ideal picture map of hospital units.

At this meeting, it was important to maintain a patient-centred vision, to build a trajectory that would serve it, to go beyond each single sector to create a global vision and to reach a consensus.

Result

The ideal picture map of hospital units follows the guiding principles of the project.

Stats

• 65 participants
• 25 topics explored
• 23 hours of reflexion
• 3 days of work

 

Developing the future organizational chart

Objectives

Using 2D and 3D models, participants identified the essential, important and desirable links between the functional units of the hospital – such as the emergency department (ED) and the intensive care unit or the ED and the operating room – and then created an organizational chart.

The consulting firm Groupe Solutions Systémiques (GSS) joined the project team to bring its expertise in Lean Design to the planning process of the future hospital.

Results

The organizational chart, which is the backbone of the project, illustrates the essential and important proximity links between hospital units.

Stats

• 65 participants
• 4 activities
• 12 scenarios of proximity between units explored
• 2 days of work

What participants said

• The commitment of the participants to the improvement of care at Lachine Hospital is truly remarkable! A really nice team!
• Very nice workshop and progress of the project. Nice work from the team.
• It is an honour for me to participate in the future of the hospital, with which I have always felt a great sense of belonging.

 

Developing the architectural integration scenario

Objectives

Participants evaluated five different layout scenarios. Using an evaluation grid that integrated the clinical and functional components, they identified the strengths and weaknesses of each scenario. Based on this evaluation, two new and improved working scenarios were formulated.

It was important to be aware of the constraints and possibilities of the site and the Lachine Hospital building, while respecting the expectations of the hospital staff and the requirements of the Société québécoise des infrastructures (SQI) and the Minister of Health and Social Services (MHSS).

Result

Scenario "A" received the highest evaluation grade and became the reference for the next workshop.

Stats

• 75 participants
• 5 activities
• 7 scenarios explored
• 2 ½ days of work

What participants said

• Modernization is happening in the near future; I will be able to see the result and work in the new spaces!
• As a patient, I find it incredible to be able to actively participate and to feel listened to.
• It is by pulling everyone`s objectives that you realize that this project is much more complex than we thought.
• I'm happy to be able to contribute!

 

Exploring operating models

Objectives

Workshop 5 took place in two stages:

In the first stage, participants received a White Belt practical training in Lean Six Sigma for two days. They were able to learn the Lean Six Sigma principles, philosophy and methodology in order to later apply them in a concrete fashion by mapping the current mode of operation of the hospital.

The Lean approach as it applies to health care aims to decrease the amount of waste that arises from processes and to improve fluidity through systemic and interdisciplinary analysis, rather than seeing things in a segmented fashion, broken down by department or specialty. Eliminating irritants and waste is intended to achieve three benefits:

• Improving the patient's quality of care experience.
• Decreasing irritants for professionals.
• Decreasing the costs of management and operation.

The second stage consisted of four Lean Kaizen 3P workshops (patient, process, preparation). The participants were divided into four groups: outpatient services, emergency and intensive care, operating room and endoscopy, and clinical support and logistics.

For each of these sectors, the groups incorporated the lessons of the Lean in order to understand the current mode of operation with respect to patient experience, processes, and the ways in which work and space are organized. They also defined opportunities for improvement, allowing for the development and testing of several ways to organize the sector in the future as part of the modernization of the Lachine Hospital.

Result

Several spatial layout possibilities, where the participants were able to sketch out efficient future modes of operation. See an example here.

Stats

• 118 workshop participants
• 30 activities
• 27 scenarios explored
• 10 days of work
• 52 Lean White Belt certifications

What participants said

• We started with blank stares and ended up creating scenarios which respected patient flow, dignity, the mutual use of space, etc. Amazing evolution. Can't wait to see the result.
• Very interactive workshop - high energy. I greatly appreciated the knowledge of hospital employees and their dedication.
• The total participation of the Lachine staff in attendance is the element that will make this project excel.

 

Sharing the results of the workshops

Objectives

On June 6, 2017, representatives who participated in Lean Design workshops to help plan the modernization of Lachine Hospital gathered in a large room at the Congregation of Sisters of Saint Anne. They were there to celebrate the end of this essential phase of the Hop Lachine! modernization project.

“We are here to celebrate the end of this stage, but also to recognize the dedication and enthusiasm of all participants," said Chantale Bourdeau, clinical administrative coordinator of the Lachine Hospital and the Camille-Lefebvre Pavilion of the McGill University Health Centre (MUHC). “Your contribution to the success of the workshops and to this project is invaluable. Your dedication to our community and university hospital is highly appreciated.”

According to Imma Franco, former director of Technical Services and Real Estate Planning, the benefits of this transformation will be numerous.

“The Hop Lachine! modernization project aims high,” she said. “We want to address infrastructure issues and improve facilities to provide a safe and effective healthcare and work environment that facilitates healing.”

The diversity of experiences and points of view of all participants is one of the strengths of the project, but it also presents challenges, as Dr. Serge Carrier, urologist and surgical director of the Lachine Hospital, explained.

“During the workshops, everyone had to go beyond the reality of their sector and have a global vision,” he said. “Together, we had to reach a consensus and build the subsequent activities according to this consensus.”

The results of the workshops

The highlight of the event was the tour of the workshops. Members of management and managers were invited to visit 12 information booths, where facilitators shared with them the work completed by the diverse teams over the past few months.

Also in the program of this memorable morning: a recollection of highlights, a questionnaire on the experience of participants, a summary of the next steps, a prize draw, and pizza and cake!

Participants

• Ewa Sidorowicz, Assistant Director General, Medical Affairs; Director of Professional Services (DSP); and Project Sponsor
• Imma Franco, Director, Technical Services and Real Estate Planning and Project Sponsor
• Patient partners
• Hop Lachine! ambassadors
• Planning and coordination teams
• Lachine Technical Services team
• Representatives of the departments of Quality, Human Resources, Finance and Communications of the MUHC
• GSS Inc.
• Congregation of Sisters of Saint Anne

What participants said

• This collaborative exercise required great openness, solidarity, patience and a good dose of humour to finally arrive at the key moment of each stage, what we call the thumbs-up. - Chantale Bourdeau.
• The decisions made consensually will improve patient safety, quality of care and fluid care pathways; the hospital's work environment will not only be efficient, but also enjoyable and stimulating. - Dr. Ewa Sidorowicz