In 2015, the Veterans Health Administration (VHA) designated Lean as the process improvement methodology. VHA leadership, program managers, and frontline staff across 171 medical centers and over 800 Community-Based Outpatient Clinics (CBOCs) were unable to consistently track and share their Lean improvement work, limiting the ability to identify and share strong practices.
Systems Redesign & Improvement (SR&I) solicited baseline voice-of-the-customer (VOC) information on the current state of project documentation, tracking, and sharing at individual facilities or Veterans Integrated Services Network (VISN) centers. SR&I then reviewed VOC information to determine gaps and to create a vision and design for the future state.
VOC findings revealed that Lean project documentation, tracking, and sharing processes were widely inconsistent throughout the VHA. Some were using a project repository hub, and others were tracking and sharing at the facility level only. Visibility of Lean projects and sharing of strong practices was limited.
SR&I led the development of an enterprise-wide electronic system to organize, document, and track improvement projects, supporting the sharing of strong practices. Challenges included organizational size and user learning curve. Approaches included use of agile method, VOC and PDSA cycles during development, and an adoption toolkit for implementation.
Tool usage has grown from 750 improvement projects entered in FY20 to 10,681 in FY21. Customer feedback enhancements were incorporated; it is currently in its third version. The ability to create reports and dashboards has enhanced value and sharing. These reports are being incorporated into annual reports to support sustainment.