1. It's here. Many big healthcare systems claim are "all in" with Lean an essential part of their operating strategy.
If this year's Lean Healthcare Summit is any indication, the Lean movement in healthcare is growing. I counted 16 well-established healthcare brands with delegations of 10 or more C-suite members, medical directors, and process improvement experts. To me, that's a sign senior leadership at these organizations believes Lean has the potential be as transformative to healthcare as it was to manufacturing.
2. It's changing. The trajectory of healthcare's Lean journey is fundamentally shifting from "Kaizen" to "Model Cell." Leaders have come to realize that department-level rapid improvement events (kaizens), while positively exposing staff to Lean thinking, don't always translate to bottom line results.
For example, when an ED determines that the waiting area is becoming congested with waiting patients the application of Lean techniques can alleviate the problem by moving people through a simultaneous registration, nurse workup, and provider assessment. This change drastically reduces ED length of stay and increases ED capacity. While the ED is rightfully recognized for a successful Lean project, more admitted patients may wind up boarding. To avoid excessive boarding, some patients are sent to the first available floor bed which may not be appropriate for their diagnosis leading to a longer than necessary stay. More transformative steps have to include scaled initiatives that eliminate constraints to patient flow from end to end (model cell) that increase throughput and revenues.
3. It's challenging. Lean can challenge the management hierarchal pyramid. In a Lean culture, waste is eliminated through the efforts of front line workers every day. Executives and managers focus on supporting this activity through their own personal example of daily standard work and by intentionally removing barriers to change for their teams. In a sense, the front line employee occupies the top of the pyramid being supported by management. Lean executives are still adapting to the leadership skills needed for this culture.
4. It's working. Initially borrowing Lean techniques from manufacturing, Lean healthcare has developed some unique tools of its own. EHR Adoption and Patient Portal are just a couple of the tools that Lean healthcare leaders must deploy effectively in order to create value in patient care. Provider proficiency with EHR smart sets and smart phrases, for example, eliminates waste, creates value, and improves patient care.
5. It's being measured. Benchmarking and comparative analytics are still necessary to identify priorities for Lean transformation. While the Lean standard is perfect care with anything less calling for improvement effort, systems still need to identify their sources of greatest waste. Comparative benchmarking analytics provide both an external and internal view into these opportunities.
6. It's demanding. Physicians must provide leadership for successful Lean transformations. Lean thinking is rational, scientific, and engaging to physicians. Capture their imagination with Lean ideas and encourage them to step forward. Their excitement over the possibilities for change is contagious. A large AMC recently "leaned" their OB/GYN scheduling system when the medical director understood the potential to reduce waits and appointment no-shows.
7. It's leading the way. Lean is not just about eliminating waste from operations. A Lean health system develops people at every level to solve problems and create value. Check out some of the successful models for this development process at leading Lean hospitals
Is Lean being applied effectively in your organization? Is it becoming part of your culture or are folks simply going through the motions?
Bill Booth is a Senior Director with iVantage Health Analytics. Booth comes to iVantage from Healthcare Transformation Resources, a Healthcare Technology Adoption
consultancy. Before joining HTR Booth led the design and implementation of innovative inpatient care management, critical care patient flow, and revenue cycle initiatives at Christiana Care Health Services in Newark and Wilmington Delaware.
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