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- Jarebrant, Caroline, et al.
(författare)
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Development of a tool for integrating Value Stream Mapping and ergonomics in healthcare - A Nordic Multicenter study.
- 2014
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Ingår i: The 7th Nordic Working Life Conference. Book of Abstracts and Programme. - 9789198119558 ; , s. 123-124
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aim: To present the most recent draft Nordic version of the ErgoVSM tool for healthcare and some contextual factors influencing the intended impact of the tool. Material and Methods: The ErgoVSM tool is tested at 7 wards on 4 different hospitals in Denmark, Iceland and Sweden. The tests include assessment of tool usability and main factors facilitating or inhibiting the intended impact of the tool. On the basis of these trials a final version of the ErgoVSM is developed. The ErgoVSM tool: According to common VSM procedure the Current State is mapped (visualized) followed by a similar procedure regarding a wanted Future State. The Ergo-module includes assessments of physical exposures (posture, forces, variation, porosity) and psychosocial exposures (demands, control, variation, communication, porosity). It focuses task as well as values stream level. The exposures are assessed by ratings scales with verbally defined end points. The analysis includes discussion of solutions and establishment of an Action Plan needed to realize the wanted Future State. Main contextual factors influencing the intended impact of the tool seem to be previous Lean experience, management style, volume of competing projects and type of value stream analysed.
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- Jarebrant, Caroline, et al.
(författare)
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ERGONOVA Workbook. Ergonomic Value Stream Mapping in health care
- 2013
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Preface to the present English edition: This edition has been translated and printed as part of the Nordic Multicenter Study "A Nordic work environment complement to Value Stream Mapping (VSM) for more sustainable patient flows at hospitals – A NOVO Multicenter study", funded by the Nordic Council of Ministers. The present prototype version of the Workbook is now evaluated at 14 hospital wards in Denmark, Iceland and Sweden. We aim to deliver a revised Workbook for intervention processes towards increased sustainability of patient flows based on our specific Nordic opportunities with our strong tradition of agreement between the parties (cf. ‘the Nordic Model’).Jörgen WinkelProject leader of the Nordic Multicenter StudyCaroline JarebrantProject leader of the Swedish project
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- Jarebrant, Caroline, et al.
(författare)
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Previous experiences of Value Stream Mapping (VSM) at the hospital units included in the Swedish part of the NOVO Multicenter Study
- 2012
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Ingår i: Abstract book. 6th NOVO symposium. - 9789163723803
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Konferensbidrag (refereegranskat)abstract
- Within the county councils of Sweden (hospitals, elderly care, etc.) two waves of introduction of Lean Production (Lean) have occurred. The first occurred during the 1990s and was unsuccessful mainly due to dramatic and negative impact on the employees (Härenstam et al, 1999). The 2nd wave started after the turn of the millennium. In 2011 about 80% of the county councils were running Lean projects (SKL, 2012). Now more emphasis was put on leadership and teamwork as well as knowledge on methodology. Successful projects creating e.g. more efficient patient flows are supposed to save time. A key issue is, however, that no general agreement seems to occur on how these saved resources should be reprioritized (cf. the “50/50-basis” in Denmark). Due to this, Lean projects are often perceived as “saving projects” where staff will eventually be phased out leading to further “work intensification”. VSM is a main Lean tool used to reduce waste in production flows. Our present case studies show differences between hospitals in Lean and VSM experiences. At one hospital Lean has been developed from "below" in the organization since 2004 through successive education (SkaS-guiden 2008). In our 2 cases from this hospital the initial steps of VSM were guided by internal Lean educated stakeholders. No resistance was met from any employee. However, the writing of action plans and the following actions were integrated in parallel rationalization processes. In contrast, our 2 other cases at another hospital had only been marginally influenced by Lean. The VSM processes were guided by an external Lean educated stakeholder (one of the authors). Especially one of the cases had significant difficulties in achieving consensus on an action plan including work environment issues. The required time for the VSM analyses became considerably prolonged, partly related to lack of Lean and VSM experience. Conclusions: The duration of the VSM process seems to depend on previous Lean experiences. Problems in the assessment of an action plan, an essential part in the VSM procedure, seems partly due to employee uncertainty regarding the consequences for the individual and parallel rationalization processes.
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