The Truth about Lean Healthcare

Why we are the enemy when it comes to healthcare process improvement.

I originally posted this article as a comment here and it won me a copy of Lean Hospitals.

Healthcare organisations in Canada and the US have been the first to introduce lean thinking, and there is top management support for it in some of the major healthcare organisations in these countries such as the Mayo Clinic, in Rochester, Minnesota, and the University of Colorado. There is also a plethora of practical case studies from them that demonstrate lean thinking’s successes.

As a result, several NHS trusts such as Wirral Hospital NHS Trust, Merseyside, are currently introducing lean thinking in their efforts to streamline services.

In the book, “Lean Six Sigma for Service”, there is an outstanding case study from Stanford Hospital and Clinics in which they have seen a drop in the mortality rate of 48% as well as costs savings of 40% since using lean six sigma. Also Park Nicollet Health Services have begun using Lean and Kaizen within there CFO offices and have been seening great results from it.

Successful promotion of lean health care across the UK depends however on gaining both the support of government and the NHS at executive level. If this is won, implementation of lean thinking at organisational level can be achieved by the strategic training of relevant staff members. The potential benefits of lean thinking are:

• Shorter patient waiting times
• More patient admissions and diagnoses
• Faster bed turn arounds
• Improved workplace organisation, cleanliness and safety
• Less inventory used and better use of space
• Better and more streamlined administration processes
• More efficient patient record and appointment processes
• More timely and efficient delivery of care
• Better supply and storage management

As the cost of health care continues to rise, the NHS is put under increasing pressure to reduce costs while improving patient safety and care, and reducing errors and the resulting litigation.

New discoveries in medicines are being made, and new treatments are being developed, at a rapid pace, but these will be no more important to healthcare services in the future than the results of lean thinking.

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The associate chief of staff of mental health services at the University of Arkansas for Medical Sciences Jeffrey Clothier offers a glimpse of this future when he comments on how services are commissioned and used:

‘Some systems already allow patients to go online and select their appointment time without ever speaking to a clerk. The services they pull will be those that have value for them. Lean will provide the basis for understanding the value-added activities that will compose personalised medicine.’

Applying lean thinking to the healthcare sector can provide significant cost and process efficiencies. However, to realise and sustain these benefits fully, there is an urgent requirement to educate and empower healthcare staff in the principles and methodologies involved. Education and training in lean thinking should be part of organisations’ competency frameworks to ensure consistency across all functions.

Relevant links:

http://www.childrensmn.org
http://www.vha.com

Read this storyand then follow up with this one

On December 30, the New York Times published a shocking op-ed by Dr. Atul Gawande revealing that the administration has brought a halt to the life-saving checklist program both in Michigan and at Johns Hopkins:

”this past month, the Office for Human Research Protections shut the program down,”

Gawande writes.

”The agency issued notice to the researchers and the Michigan Health and Hospital Association that, by introducing a checklist and tracking the results without written, informed consent from each patient and health-care provider, they had violated scientific ethics regulations. Johns Hopkins had to halt not only the program in Michigan but also its plans to extend it to hospitals in New Jersey and Rhode Island.

“The government’s decision was bizarre and dangerous,”

Gawande adds.

”But there was a certain blinkered logic to it, which went like this: A checklist is an alteration in medical care no less than an experimental drug is. Studying an experimental drug in people without federal monitoring and explicit written permission from each patient is unethical and illegal. Therefore it is no less unethical and illegal to do the same with a checklist. Indeed, a checklist may require even more stringent oversight, the administration ruled, because the data gathered in testing it could put not only the patients but also the doctors at risk — by exposing how poorly some of them follow basic infection-prevention procedures.

In summary: we are the enemy when it comes to process improvement.

What do you think? Leave your comments below:

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• Lean Healthcare from The Lean Enterprise Academy
• The Lean Healthcare Academy
• Lean thinking the NHS
• The Lean Healthcare Exchange
• Healthcare Transformation
• A powerful message on lean and healthcare