Lean Enterprise Transformation in VA: a national evaluation framework and study protocol

Table 1 Characteristics of VA medical centers participating in the LET evaluation

VA facility	LET deployment date	Value stream areas	US census region	FY17 VA hospital complexity rating^b
Site A	Feb 2011	Inpatient Medicine^a	Midwest	1a
		Logistics^a
		Surgery
		Primary Care
		Mental Health
		Outpatient Medical/Specialty Care
		Operational Efficiency and Revenue
Site B	Jul 2012	Inpatient Medicine^a	West	1a
		Human Resources^a
		Emergency Department
Site C	Jul 2012	Onboarding new residents^a	South	1b
		Primary Care – hypertension, diabetes^a
		Women’s Health – cancer screening^a
		Outpatient Specialty Care – Time to consult
Site D	Jan 2013	Inpatient Medicine^a	Midwest	1c
		Administrative Efficiency^a
		Outpatient Care
		Access
Site E	May 2013	Inpatient Medicine^a	Northeast	1c
		Emergency Department^a
		Surgery
Site F	Sep 2013	Emergency Department (flow)^a	Midwest	1b
		Hiring process^a
		Open scheduling without consults
		Urology
Site G	Dec 2014	Primary Care^a	Northeast	3
		Human Resources
		Ethical Leadership Culture
Site H	May 2015	Primary Care^a	West	1a
		Lifecycle of Workforce Development^a
		Mental Health
Site I	Jun 2015	Access^a	West	1b
		Veteran Experience^a
		Community Care^a
		Clinical Care – Ophthalmology, Podiatry, and Audiology^a
Site J	Jun 2015	Inpatient flow^a	West	1a
		Human Resources - Recruitment^a
		Human Resources - Retention

FY fiscal year; LET Lean Enterprise Transformation, VA Department of Veterans Affairs
^aIndicates the clinical and non-clinical value stream areas evaluated during site visits and follow-up telephone interviews
^bThe Facility Complexity Model is a data driven model that relies on data from VHA corporate databases along with information from VA central office program offices to identify workload and programs (i.e., teaching, research, and complex clinical programs such as cardiac surgery and neurosurgery) at each facility for the purposes of comparing facility complexity. Facilities are categorized into one of five groups: 1a (most complex), 1b, 1c, 2, and 3 (least complex). 1a facilities (highest complexity) are those with high volume, high risk patients, most complex clinical programs, and large research and teaching programs

ISSN: 1472-6963