KUP

Key 5 – Quick Changeover Systems

In meeting the demands of General Practice, a Practice needs to be able to switch emphasis/ change direction both quickly and with as little pain as possible. These changeovers may come from a clinical member of staff calling in sick or a member of staff going on holiday. Alternatively to could be a change in emphasis due to a seasonal campaign. Such as the Influenza vaccination campaign.

What ever the change may be a practice should have the technology and the systems in place to meet such demands.

Level 1

Changeovers in day to day goals, such as cancelling a clinic, phoning patients etc are as seen as a necessary evil, with the emphasis on evil. Such dread is also felt for seasonal flu campaign or racing to meet the targets before the end of the year. At level one a practice may have goals but no systems or strategies to make them happen. This results in great pain when change is required. Staff scramble to decide who will do what and even frustration and anger at being “dumped” on them.

  • Discuss at meetings the importance of processes and systems in changeovers. Emphasis should be placed on how strategies make these happen (see Improvement Events).
  • There should be an understanding of how waste affects how quickly a changeover can be made (See Key 4).
  • Communication lines should be clearly defined to coordinate changeovers,
  • There is a goal set for changeover to be done in minutes.
  • Staff start to understand the need for quick changeover systems

Level 2

Processes/ systems for changeovers are defined but all staff do not understand or do not pay close enough attention to detail for changeovers to be completed smoothly. Errors and confusion still occur.

  • Provide protected time for learning the finer points of the changeover processes/ systems.
  • Promote the benefits of the learning these process to the staff, less stress, defined responsibilities. (If this is successful staff will start suggesting amendments to the processes in the Improvement Events or the SGAs. They will relate these to Key 2.
  • All staff have had training in Quick Changeover Systems.

Level 3

At level 3 time for changeovers is greatly reduced with little coordination needed as staff know their responsibilities. Phrases such as “The changeover method needed here is …” can be heard.

  • Allow SGA teams to present improvements to meetings. At level 4 teams will volunteer for changes to presented. Particularly for successful changeovers and improvements in process/ systems. (Staff become increasingly motivated if they can “show off” how they have improved how the practice works.
  • Discuss and share changeover methods with other staff either at any meeting, from huddles to Clinical meetings.
  • Reward teams that perform changeovers successfully or improve them significantly.

Level 4

  • Changeover methods permeate all members of staff at all levels from patient facing, to management to clinical.
  • Changeover methods are standard and simple.
  • Changeover methods are initiated through an agreed mechanism that allows all staff to be aware what method of changeover is currently in progress.
  • Staff feel low levels of stress when a changeover takes place.
  • Staff constantly look for methods to improve efficiency and effectiveness of systems/ processes of changeovers, even after each and every changeover. This is seems as normal practice and there is no resistance from “It’s the way it is” attitude to change.

Level 5

At level 5 quick changeovers occur at all levels and if new changeover methods are needed they are quickly created and adopted. Changeovers are so simplified/ optimised that even the newest employee can complete in a changeover event will little risk of error.