Value stream mapping is an activity that helps you understand the flow of orders, materials, and time through your productive process. This Lean tool should only be used when you are ready to make process improvement changes to your current operations by eliminating the 8 wastes. Resist the temptation to create value stream "wallpaper;"read the "Toyota Way Fieldbook" by Jeffrey Liker and David Meier. (Value stream wallpaper is a map you develop, post, and forget about for several years-it is waste in its purest form-you wasted your own and other people's intellectual abilities to create it and, then do nothing with it!)
Your process improvement leader should be the Lab Manager or Administrative Director-yes, I want this point emphasized!
If you value stream map at the process or silo level, you run the risk of becoming a GM (point kaizens) vs. a Toyota (Lean operational philosophy coupled with continuous process improvement for over 50 years). Toyota is surviving the greatest economic downturn in our lifetimes, while GM is facing bankruptcy.
The advantage of having your boss involved in value stream mapping is that it gives you high-level access to operational resources you might need when you begin to implement operational changes to create improved flow within the laboratory-things like moving computer terminals, wires, and/or temporary walls.
Value stream mapping is a paper and pencil exercise. The map is a tool that has three distinctive parts:
Flow of orders,
Flow of materials, and
Timeline from specimen procurement at the patient-level to report receipt by the clinician.
The value we create in the laboratory is the information we provide to physicians who are treating patients within our communities, i.e., we analyze blood and tissue to extract patient-related information for use by doctors who are treating patients. The more waste we eliminate from the value stream, the faster we provide the results to the doctor. Most acute care hospital laboratories have three to four value streams: the clinical laboratory value stream, the anatomic pathology value stream, and the microbiology value stream. Feel entirely free to slice and dice your definitions of the laboratory differently-the streams or product families mentioned above have proven themselves useful to me in my company's Lean practice with Lab clients.
The actual current state map is a simple diagram of every step involved in the flow of a specimen and the information to bring an order to final report delivery. Each step in the value stream is represented as a process box, e.g., phlebotomy, specimen processing, technical analysis, report generation, and report delivery. It is common to insert an inventory icon before each step, especially, if specimen are stockpiled or batched before being analyzed. The Lean Enterprise Institute (http://www.lean.org/) has a Value Stream Mapping workshop that is available for purchase that lists all the clever icons typically used to map a process. Caution-it is in manufacturing speak-so you will probably have to study it a bit to adapt it to a lab environment.
Within each process box you can record important information like number of staff members by shift, typical batch size before moving the specimens to the next process step, number and type of analyzers or equipment used in the area, or if the area experiences large specimen drops throughout the day detail when and how many specimens.
Once you have mapped your current state value stream, you are ready to brainstorm some process improvement initiatives with your lean team. Your current state map shows the wastes--over production (big batches), specimens placed in inventory, wasted motion, transportation wastes (hauling specimens to different parts of the lab), unnecessary sorting, defects passed downstream, and lack of problem solving and best practices at the staff level. These are the wastes you want to see and eliminate-your future state process improvement opportunities. Toyota believes that being able to see a problem is a very good thing-you are then able to eliminate it; they worry when their staffs are not reporting problems.
Congratulation--you now have a current state map for one of your value streams and have worked with your Lean team to brainstorm some process improvement opportunities. The next action you need to do is to prioritize which process improvement kaizens you will do first, second, third, etc.
After you prioritize your process improvement sequence you are ready to generate your future state map. Redraw the current state map into your future state map using kaizen burst icons (star bursts) labeled with the process improvement initiatives you plan to undertake. Develop your action plans and implement the improvement fast-remember that part time teams equate to full time excuses.
I would very much like to hear your comments and suggestions about value stream mapping. I have found that the more I use it, the easier it gets. Please share your insights with all of us Lean laboratory practioners. Have a great Memorial Day weekend and remember those, both present and past, who protect our country and our freedoms.