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Healthcare Lean Six Sigma - How to do a Waste Walk Exercise with strategic intent

Posted Jul 15 2009 8:10pm

As with everything it is crucial to identify the pain points and try to resolve them, this practice in Healthcare Lean Six Sigma is know as the waste walk. Commonly waste walks are exercises where a senior leader and a department's management team walks around identifying bad process which can be wasteful. However, with this mechanism the bang for the effort gets lost in the weeds. I relate this practice to the influx of tasks, without the structure of the overall goal. So let's start with the overall goal, of improving the process from the customer's perspective. Let's identify our customer.

First, obtain a cross collaborative team for a single process flow from a larger level. For our example, let's review the revenue cycle flow from scheduling through billing. Notice that I didn't break it down into all of the sub processes, we went for the big picture. Have the team meet and map out the entire current state of the process. This is a considerable effort and often overlooked. However, if you don't have your current state, it will be difficult to identify those changes which will transform your organization.

Now, that everyone understands the big picture, perform the waste walk. Take a couple of hours, over a couple of days and as a cross-functional team identify sources of waste. What will be enlightening to watch is the biller's perspective change when the registration process is viewed or the registrar when it comes to billing rework.

Afterwards, gather the team together and review the opportunities against the larger process flow. Map out the to-be state, clearly identifying process improvement points which add to the overall value of the process. The team should be focused on eliminating bottlenecks and rework.

Afterwards identify the gaps, these gaps are referred to as conflicts in the Healthcare Lean Six Sigma jargon. All can be summarized in a conflict resolution diagram.

Finally, charter the initiative while focusing upon resolving the conflicts. Remember to get some quick wins, as you will be changing the organization, and place effort on those items which are worth the effort.

The good news is you have performed your waste walk and used the exercise to drive customer improvements from a system view instead of just departmental.

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