Lean management has increasingly become a method of choice for hospitals seeking a creative solution to cost and quality problems. However, its manufacturing roots can make Lean a challenging process improvement model for hospitals to fully adopt. Marc Hafer, CEO of Lean transformation company Simpler Consulting, shares four common mistakes hospitals make when implementing Lean, and how to avoid them.
1. Not devoting enough resources. One of the most common mistakes hospitals make when adopting Lean is not devoting enough resources to Lean projects, according to Mr. Hafer. Transforming hospital processes with Lean requires a commitment of time and energy by leaders and staff. Hospitals should have one person or a team of people responsible solely for Lean projects instead of relegating Lean as a side project for staff. "Very few hospital organizations, when we've started with them, have had the kind of infrastructure with dedicated resources [required]," Mr. Hafer says. "Failure mode is they will take a department like quality or human resources or organizational development, and assign someone responsibility for Lean on a part-time basis."
Assigning a staff member to Lean full-time does not necessarily mean other departments will be short-staffed, however. Employing Lean techniques streamlines processes and can allow hospitals to redeploy staff members to different areas in the hospital, according to Mr. Hafer.
2. Leadership not fully engaging in Lean. In addition to the need for full-time commitment by at least one staff member, Lean requires leaders to be fully engaged in the adoption of Lean management. "The classic under-resourcing and delegating from the corner office — those two things combined are the death of Lean transformation," Mr. Hafer says.
Transforming a hospital to Lean means shifting the organization to an entirely new way of thinking about and designing processes, which requires full involvement of hospital leadership. The level of engagement Lean demands of leaders may be a new experience for hospital executives, according to Mr. Hafer. "[Hospital leaders] have been able to do IT projects — implementing electronic medical records — or other projects in the past by delegating and assigning this to someone that they may touch base with on a monthly or quarterly basis for review; it wasn't hands-on," he says.
3. Getting stuck in trials. When first adopting Lean, many hospitals start with pilot projects to evaluate its effectiveness. "Healthcare especially likes trials, likes to have proofs of concept that are validating their philosophy they can then incorporate into future strategies," Mr. Hafer says. Many hospitals start with projects in the emergency department or operating room, he says. While it is useful to run pilots and start slow, hospitals will need to move beyond this stage to take full advantage of Lean.
"At a certain philosophical level [hospital leaders] might understand initially the potential of Lean to change their strategies," Mr. Hafer says. "It takes a little bit of time for them to become true believers in what's possible." Hospitals should use a Lean approach to all areas of the hospital — not just clinical areas. For example, hospitals may use Lean to improve their revenue cycle processes, Mr. Hafer says.
4. Not standardizing practices. Another common mistake hospitals make is not standardizing practices. Continuous improvement, one of the key goals of Lean, relies on standardized work. "One of the big challenges in healthcare is getting these highly educated, highly trained individuals [working in a hospital] to agree on what best practices are and to agree on conforming to standardized work," Mr. Hafer says. "Without standardized work, there can be no continuous improvement."
Education is the solution
To avoid these mistakes, hospitals need to become educated in the Lean method and philosophy. Hospitals can then better understand how to use Lean as part of their strategy to meet goals. "It starts with education, then creating their strategy around lean," Mr. Hafer says. Hospital leaders need to ask themselves "what is the new vision of the organization going forward and how can Lean enable the vision to become a reality?" he says.
Lean is a "fundamental course correction in the life of an organization," Mr. Hafer says. To successfully make this change, hospital leaders need to first evaluate their hospitals' culture, mission and vision; educate themselves on Lean practices and then establish how they can use Lean to support their culture, mission and vision.
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1. Not devoting enough resources. One of the most common mistakes hospitals make when adopting Lean is not devoting enough resources to Lean projects, according to Mr. Hafer. Transforming hospital processes with Lean requires a commitment of time and energy by leaders and staff. Hospitals should have one person or a team of people responsible solely for Lean projects instead of relegating Lean as a side project for staff. "Very few hospital organizations, when we've started with them, have had the kind of infrastructure with dedicated resources [required]," Mr. Hafer says. "Failure mode is they will take a department like quality or human resources or organizational development, and assign someone responsibility for Lean on a part-time basis." Assigning a staff member to Lean full-time does not necessarily mean other departments will be short-staffed, however. Employing Lean techniques streamlines processes and can allow hospitals to redeploy staff members to different areas in the hospital, according to Mr. Hafer.
2. Leadership not fully engaging in Lean. In addition to the need for full-time commitment by at least one staff member, Lean requires leaders to be fully engaged in the adoption of Lean management. "The classic under-resourcing and delegating from the corner office — those two things combined are the death of Lean transformation," Mr. Hafer says.
Transforming a hospital to Lean means shifting the organization to an entirely new way of thinking about and designing processes, which requires full involvement of hospital leadership. The level of engagement Lean demands of leaders may be a new experience for hospital executives, according to Mr. Hafer. "[Hospital leaders] have been able to do IT projects — implementing electronic medical records — or other projects in the past by delegating and assigning this to someone that they may touch base with on a monthly or quarterly basis for review; it wasn't hands-on," he says.
3. Getting stuck in trials. When first adopting Lean, many hospitals start with pilot projects to evaluate its effectiveness. "Healthcare especially likes trials, likes to have proofs of concept that are validating their philosophy they can then incorporate into future strategies," Mr. Hafer says. Many hospitals start with projects in the emergency department or operating room, he says. While it is useful to run pilots and start slow, hospitals will need to move beyond this stage to take full advantage of Lean.
"At a certain philosophical level [hospital leaders] might understand initially the potential of Lean to change their strategies," Mr. Hafer says. "It takes a little bit of time for them to become true believers in what's possible." Hospitals should use a Lean approach to all areas of the hospital — not just clinical areas. For example, hospitals may use Lean to improve their revenue cycle processes, Mr. Hafer says.
4. Not standardizing practices. Another common mistake hospitals make is not standardizing practices. Continuous improvement, one of the key goals of Lean, relies on standardized work. "One of the big challenges in healthcare is getting these highly educated, highly trained individuals [working in a hospital] to agree on what best practices are and to agree on conforming to standardized work," Mr. Hafer says. "Without standardized work, there can be no continuous improvement."
Education is the solution
To avoid these mistakes, hospitals need to become educated in the Lean method and philosophy. Hospitals can then better understand how to use Lean as part of their strategy to meet goals. "It starts with education, then creating their strategy around lean," Mr. Hafer says. Hospital leaders need to ask themselves "what is the new vision of the organization going forward and how can Lean enable the vision to become a reality?" he says.
Lean is a "fundamental course correction in the life of an organization," Mr. Hafer says. To successfully make this change, hospital leaders need to first evaluate their hospitals' culture, mission and vision; educate themselves on Lean practices and then establish how they can use Lean to support their culture, mission and vision.
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