Learning Lean at Sutter Health


Andleeb-DombrowskiBy Andleeb Dombrowski, MBA, RT (R) (CT) 

As one of the 23 participants in the 2014 AHRA Partners in Learning program, I was very excited to see what I would learn and share with Sutter Health Pacific Medical Foundation in Santa Rosa, CA when I did a site visit in August. After being provided with an overview of operations by Bob White, Director of Ancillary Services, I met with the department manager and team leads to discuss the various ways that Sutter Health has improved patient care and workflows and, most importantly, decreased waste.

Every facility has their challenges in improving patient care: access, staffing levels, productivity, and efficiency are high on the list, as well as supply costs. If there is an abundance of supplies then your costs are high, which will make your facility less affordable and thus less competitive in today’s market. I was thoroughly impressed with how Sutter Health puts Lean methodology at the heart of every action they take. By spending time with the various modality team leads and the department manager, I learned how Sutter Health keeps Lean in mind at all times, keeping only necessary supplies on hand and consistently being efficient with their stock.

I asked Bob if I could spend more time with their Lean specialist, and he happily obliged. I spent a couple of hours with Dawitt reviewing Value Stream Mapping, understanding what a Kaizen event is and how to address it, and laying the foundation of Lean with the five S’s: Sort, Set in Place, Shine, Standardize, and Sustain. Dawitt provided me with an overview of a current project to improve patient access in one department. He then showed me how the staff discusses what the current state looks like, what makes the status unacceptable or troublesome, and what the future state would look like when everything has been resolved. This includes training, reorganizing the department, adjusting hours, and ensuring the needs identified by the group are met and everyone is in agreement.

To help me further see the importance of the Lean process, Dawitt took me to a family practice office to see their work “at work.” The team had identified a concern, and everyone worked together on a solution. There were cards for staff to use to round on their work areas and a bulletin board to track any outstanding concerns. He also walked me through their supply closets to demonstrate how all supplies were arranged/accessible, and how if supplies were running low, then Kanban cards were filled out and placed in one location for the supply center to pick up and replenish. It was a great way to keep track of supplies that were actually needed versus what staff thought might be needed or was already ordered. It was a much cleaner process that could easily be sustained.

I was also able to visit Sutter Health’s new regional hospital slated to open next month. It was wonderful to see how the staff were working through simulations of where equipment would reside in the various areas. Would this work for the staff? The room? The patient? Is it efficient? Will this help keep our staff on task, or will they have to keep leaving the room or taking extra steps to get the items they need to provide care for the patient?

I am very grateful for the opportunity provided by AHRA and GE Healthcare to visit another facility, make new connections, share best practices, and bring home something valuable that we can establish in our facilities. I walked away with many notes to share with my management team. However, the biggest impact of my visit to Sutter Health was the thorough overview of their Lean process that I can now use to benefit my own facility.

Thank you to Bob White and his wonderful management team for hosting me and answering all of my questions. This was truly a partnership in learning, and I was very happy to be a part of it.


Andleeb Dombrowski is the imaging operations manager hospitals at Kaiser Permanente PNW in Portland, OR. She can be reached at andleeb.dombrowski@kp.org.

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