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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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| 2. |
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| 3. |
- Jarebrant, Caroline, et al.
(författare)
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Ergonomic Value Stream Mapping (ErgoVSM). Tool and User Guide.
- 2016
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Ingår i: Nordic Council of Ministers, ANP 2016:731. - : Nordic Council of Ministers. ; :APN 2016:731
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Recent years Lean Production (”Lean”) has become a prevalent rationalization strategy in healthcare to create more efficient value streams. Research shows that this often results in impaired Ergonomics, i.e. impaired work content and physical work load (“physical ergonomics”). A common Lean tool used to rationalize value streams in healthcare is Value Stream Mapping (VSM). An ergonomic “add-in module” Ergonomic Value Stream Mapping (ErgoVSM) – has therefore been developed to be used as an integrated part of VSM in the analysis of value streams in healthcare. ErgoVSM as well as VSM are participative tools. All occupational groups performing tasks directly related to the investigated value stream should be represented when using the tool. This Guide includes description of methods and assessment templates for physical ergonomics and work content. An initial version of ErgoVSM for manufacturing industry was developed in Sweden. Later, this was further developed for the health-care sector. This tool was then evaluated in a Nordic Multicenter Study by national projects in Sweden, Denmark and Iceland. The Nordic evaluation showed that using the ErgoVSM tool may result in more focus on ergonomics in the Action Plans compared to just using VSM. This is obtained without jeopardizing performance aspects. Based on the field experiences from the Nordic Multicentre Study I, the ErgoVSM tool was further developed, resulting in this present English version.
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| 5. |
- Winkel, Jörgen, 1946, et al.
(författare)
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A Nordic evaluation of a work environment complement to Value Stream Mapping for increased sustainability of patient flows at hospitals - The NOVO Multicentre Study I
- 2015
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Ingår i: Abstract book, The 9th Novo symposium: Sustainable Health Care Production Systems. ; , s. 34-36
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Konferensbidrag (refereegranskat)abstract
- Conclusions: •Both the ErgoVSM and VSM tools seem mostly to result in intervention proposals causing improved or no change in the work environment without impaired performance. •Based on Swedish data only the use of ErgoVSM may result in some improvement of the work environment compared with VSM. Such an effect is weakly supported by the Icelandic data and not by the Danish data. Thus, only under some conditions the ErgoVSM tool may be used in favour of the VSM tool. •Most proposals were assessed to cause ergonomic improvements at system level (‘job content’ and ‘work situation’). This is in contrast to intervention proposals investigated in the ergonomic intervention literature mainly focusing task level and the individual (cf. Westgaard and Winkel, 2011).
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| 6. |
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| 7. |
- Winkel, Jörgen, 1946, et al.
(författare)
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Facilitating and inhibiting factors in change processes based on the lean tool ‘value stream mapping’: an exploratory case study at hospital wards
- 2015
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Ingår i: International Journal of Human Factors and Ergonomics. - 2045-7804 .- 2045-7812. ; 3:3/4, s. 291-302
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Tidskriftsartikel (refereegranskat)abstract
- “Lean production” has become a prevalent rationalization methodology in healthcare. Value Stream Mapping (VSM) is a commonly used Lean tool to identify non-Value-Adding-Work. VSM is a participatory tool. Thus it may offer an opportunity to combine interventions for improved performance and ergonomics. The aim of the present exploratory study is to report observations that seem to play significant roles as inhibitors and facilitators for proper intervention processes when using VSM. Seven hospital wards have been investigated in Denmark, Iceland and Sweden. Information was obtained by screening key hospital documents and interviewing participants in and around the VSM processes. Nine tape-recorded interviews were performed. The results tentatively point to the facilitating effect on the VSM process by emphasizing involvement and decision-making among the participants, 1st line manager support and engagement, allocation of sufficient resources, work environment issues as part of the VSM methodology and VSM routines that are well-established and broadly accepted.
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| 8. |
- Winkel, Jörgen, 1946, et al.
(författare)
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Value Stream Mapping in healthcare: ergonomic implications and the significance of adding an ergonomic module - The NOVO Multicentre Study I
- 2018
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Ingår i: The 12th NOVO symposium : Care integration, systems reform and sustainability in health care, Helsinki, 15-16 November. - Helsinki, Finland : Juvenus Print - Finnish University Print Ltd. - 2323-363X. - 9789523431959
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Konferensbidrag (refereegranskat)abstract
- Background: During the recent decade “Lean production” has become a prevalent rationalization methodology in healthcare. A commonly applied Lean tool is Value Stream Mapping (VSM). It is a participatory tool, i.a. used to identify non-Value-Adding-Work (non-VAW) in patient flows. The process results in an Action Plan suggesting interventions aiming at minimizing non-VAW in order to increase the proportion of value creation. Scientific evidence indicates that non-VAW often represents periods of physical and mental recovery. Reduction of non-VAW may therefore cause ”Work intensification”. On this background the VSM tool has been complemented by an ergonomic module (ErgoVSM) to be used in the healthcare sector (Jarebrant et al., 2010). The aim of the present study was to investigate differences in Action Plans regarding expected impact on ergonomics and performance issues when using ErgoVSM rather than VSM. Material and Methods: Fourteen hospital wards were investigated, six in Denmark, two in Iceland and six in Sweden (one VSM ward refused to complete). In each country half the wards used VSM according to their ordinary Lean routines and the other half used ErgoVSM. All action plans were collected and each proposal was analysed based on triangulations between different stakeholder assessments. Data were analysed using Fisher's exact test of contingency tables of impact on four factors: Work Environment (WE, +/0/-), task/job content/system and efficiency according to VSM/ErgoVSM. Results: Of a total of 175 proposals from all the investigated wards 106 were assessed as causing WE+, 8 WE-, 20 WE0, and 41 Not Assessable. Of the 106 WE+ proposals 78% aimed at system level changes (job content and work situation), the remaining at task level changes or not assessable. This is in contrast to the intervention proposals generally investigated in the ergonomic intervention literature focusing almost exclusively interventions at task and individual level. Using ErgoVSM rather than VSM in Sweden and Iceland resulted in a higher proportion of proposals aiming at reduction of ergonomic risks compared to the Danish wards (p=0.02). Using ErgoVSM did not result in fewer proposals aiming at improving efficiency (p=0.5). Conclusions: Integration of ergonomic criteria into the rationalization tool VSM seems to imply a potential for more comprehensive ergonomic improvements without inhibiting the development of proposals improving efficiency. However, this impact of ErgoVSM seems to be modified by contextual factors.
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