Optimizing the Whole

Posted on May 23, 2012 by


Often times, it is easy to for all of us to get caught up in the messy details of our daily work. That’s why when we focus on improving processes, it’s important to step back and understand the broader context of the system we are working in. The tendency is to rush in to solve problems as point improvements from where we sit, but if we really want to create change that can be sustained and will achieve the original goals we set out to achieve both upstream and downstream of us, it requires a systems or value stream approach. This is because unit efficiency does not equal system efficiency.

So what is a value stream? Simply put, a value stream is all the activities, both value added and non value added, that “flow” into the delivery of a product or service for our patients and customers. That concept seems simple enough, but the real challenge lies in seeing it and understanding what obstacles (dams, eddies,etc.) prevent that flow.

The Psych Services Improvement work is a textbook example of value stream improvement. This week, a highly engaged multi-disciplinary project team from DAJD and JHS has spent this week identifying the bookends of this value stream, learning concepts like Waste and the 3 Actuals, and walking the processes identified through direct observation. The goal at this phase is to understand Psych services from a systems view, looking at the flow of materials, information, people, and process in how we serve our psych patients in the jail. Seeing this first hand at the detailed level of the staff who perform the work has been absolutely fascinating! There have been several light bulb moments we have witnessed and we are only into the current state mapping. By looking laterally across functional areas, which is how value flows, it will greatly shed light on ideas for optimizing the whole.