Mount Sinai Morningside Hospital employed lean management techniques to design its vaccination site, according to a March 12 article published in Harvard Business Review.
Lucy Xenophon, MD, chief transformation officer at the New York City-based hospital shared these five steps Mount Sinai took to get started:
1. Define the challenge
Mount Sinai Morningside's journey to create an efficient vaccination site started with a problem statement: We need to vaccinate X number of people per day at Y location with Z resources.
2. Understand the current state
Administrators gathered data on available storage capacity at the pharmacy, the number of people trained to vaccinate, how it would schedule and register patients, the number of pharmacists available to reconstitute the drug, the number of doses expected per vial and the shelf life of the reconstituted vaccine.
Next, they planned their vaccination location site by observing the path vaccines and patients will need to take. They chose their auditorium, Dr. Xenophon said.
3. Map the process
The hospital identified the roles it needed to fill and outlined the steps each role would take. Process maps allowed the different roles to visualize potential obstacles, define roles and plan for things like efficient storage.
4. Define the Standard Work
Steps were created for each role by the people responsible for that role.
For example, a vaccinator is a registered nurse, physician's assistant, nurse practitioner, or physician who administers injections. The vaccinators are trained to use the ambulatory care version of the electronic health record to document the encounter and must have an active New York State license and active basic-life-support certification.
5. Execution considerations
Simulation of the vaccination process allowed for design considerations.
Each bay has standard supplies, and a printed set-up diagram is hung in each bay. Because vaccinators rotate, this process made it easy for the people on duty to assemble the space. The diagram minimizes the delays caused by missing items or excessive items.
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