"We particularly want to be a learning organisation"

Vitalis: Housing and care

These are the words of Frans Wuisman, a manager at Vitalis Residential Care Group, responsible among other things for the focus on results. This organisation has developed from a housing corporation into a provider of housing and care, where the emphasis has shifted more strongly towards healthcare. Besides extramural care, Vitalis provides tailored care in combination with a suitable living environment, at different locations. One of those locations is Wissenhaege nursing home, where a number of lean tools have been in use for several months now.

Lean in healthcare

The motivation was a short training course that Wuisman had followed the previous year at Arpa: “Lean and logistics in healthcare”. Wuisman: "It was one of the first lean courses that specifically focused on healthcare and it came in a time when major changes, brought about by authorities, were forthcoming in healthcare. This included the transfer from rehabilitation care from the Exceptional Medical Expenses Act to the Health Insurance Act (Diagnosis treatment combination; DTC). The lean techniques can support us, especially through these kinds of radical changes, in thinking about what we are doing, why and how we do it and how it can be done even better or differently. So I decided that we just had to give it a try. Not planning everything endlessly, but just doing it, with as an absolute maxim: keep it small and dare to make mistakes.”

Just do it

Frans Wuisman found an enthusiastic supporter in Jacqueline Mathijssen, Head of Care, Housing and Welfare, who managed to translate the initiatives to the department. She and two other department managers followed the same training. "One of the main pillars of a successful lean process is the support from within the organisation. To make this support as great as possible, we decided to involve all employees in the process from the outset, without protocols from the top, so they can just experience the process" explains Jacqueline. "We started with the improvement board, where everyone can come up with points of improvement that can be taken into consideration, including the causes and possible solutions. The board ensures that what is going on is visible to everyone. Every day we take fifteen minutes to go through all points written on the board. By using the magnetic smileys we can clarify the status of each item at a glance.

We let the green smiley, indicating that something has been successfully completed, stay there for an especially long time (up to 2 weeks) because we want to celebrate the successes together. The beauty is that anyone can contribute their ideas and join the discussion and that is exactly what happens. People organise their work as they see fit. By giving them the ownership of certain actions and the possibility to assign deadlines to it, you could see that employees felt more involved instantly. The educational level does not play a role in this. Team members accept each other’s role because it has been visualised now. Meanwhile, the idea is so strongly present in the department that the improvement board is a true phenomenon."

Weekly Schedule Boards

TnP Visual Workplace is the supplier of the boards. Wuisman came across the company, specialised in Visual Management, over the internet. "I just Googled and in the search results I saw TnP Visual Workplace. The decisive factors for our choice were speed, quality and reliability," he explains. The collaboration went so well that a new board was introduced: the weekly schedule board, to be found recently in every customer room in Wissenhaege. It acts as a link between the organisation and the customer. Frans Wuisman explains why: "Digitising patient records brings with it a high level of convenience, but on the other hand it drives us further away from the customer. Everything is in the computer, the visual stimulus is missing. That is why we make all appointments on the board , as a sort of agenda. Everyone who enters, can see at a glance what the week is going to look like for that customer. This results in more freedom of movement for the customers themselves."

To be continued

For Frans and Jacqueline, it does not end with these two boards: "We have started with the small items whose benefits were easy to gain. The goal is to end up undertaking structural improvement processes and for this the feedback from customers and their families is also needed. For our part, we will soon be using interactive boards where everyone can express their observations and comments." 

On the road towards a learning organisation

Unlike in the regular business environment, the lean process of Vitalis cannot be expressed in hard figures, but they are not intended to be. "Our product is ‘human’, the customer who comes to us, comes for care," explains Frans Wuisman. "It cannot be expressed in money and we do not want to express it that way. What we do want to achieve is that we become and continue to be a learning organisation. Because we want to be a learning organisation and give more substance to lean thinking, there will be fewer disruptions in processes. This results in an efficient benefit. Due to our willingness to learn, we continue to have an ‘open-mind’, this enables us to deal with changes more easily and we can keep focused on the thing that matters most here in Wissenhaege: the customer."