As health care costs increase at a faster rate than other products or services, health care providers, in particular hospitals, are under continuous pressure to dramatically improve service, reduce costs, improve patient safety, reduce waiting times, and reduce errors and associated litigation.
However, hospitals are not making the necessary improvements in cost, quality, and safety. A report by the U.S. HHS Office of the Inspector General finds that 20% of consecutive inpatient stay sequences were associated with poor quality care, unnecessary fragmentation of care, or both. The current organization and management of hospitals is an imperfect system that cannot effectively address these issues. Major projects to restructure hospitals, dramatically reduce cost, and improve customer care have had little impact on quality or cost.
In simplistic terms, current healthcare systems are not designed to make the process or ‘value stream’ of care flow smoothly. Healthcare services are often ‘batch and queue’, with patients spending most of their time waiting until the Healthcare Professional is ready i.e. push versus pull. As the population matures, patient cycle times in the hospitals, post-care facilities, and laboratories become key measurements that need to improve.
Our belief is that Lean Healthcare can provide a solution to successfully address some of these concerns with minimal cost but maximum benefit.
Lean in Healthcare
The essence of Lean Thinking is to eliminate waste through understanding how the patient defines value and how to deliver that value. Lean Thinking focuses on creating an efficient, waste-free continuous flow built on a pull vs. ‘batch and queue’ approach aligned with the continual pursuit of a perfect system.
Examples of Healthcare Waste:
– Redundant capture of information on admission
– Multiple recording of patient information
– Excess supplies stored in multiple locations
– Excess time spent looking for charts
– Patient waiting rooms
– Excess time spent waiting for equipment, lab results, x-rays etc.
– Excess time spent dealing with service complaints
Hospitals are made up of a series of processes with diverse lines of business. As a consequence, they need to build their delivery systems with these lines of business in mind. Hospitals need to know the businesses that drive 80% of their value proposition. They need to streamline their organization systems and processes to fully support the process required to deliver high quality care.
Commitment and support for any lean initiative needs to not only come from top healthcare management but, even more critically, from the ‘bottom up’ for implementation. Decision making and system development need to be pushed down to the lowest levels of any healthcare organization.
Management consultants are normally engaged as Lean change agents rather than as Lean facilitators. Healthcare staff should lead any Lean implementation program. These people are best equipped to understand the work environment, issues, challenges, what will work and what won’t. An empowered and knowledgeable team is therefore essential to achieve sustainable improvements and long-term success in any Lean initiative. Put simply, Lean will not work without an educated workforce.
Examples of Lean Healthcare Performance Metrics
– Improved patient satisfaction
– Increased operating room utilization
– Reduced time between procedures
– Lower tools and supplies inventory
– Reduced laboratory space
– Improved cost effectiveness
Lean Healthcare Accreditation
A new Lean Healthcare Green Belt Certification program was recently developed to enable effective staff empowerment. The on-line program represents the first International Healthcare Certification of its kind, and provides an essential ‘first step’ to not only understanding the theory but also the application of Lean tools and practices through detailed work assignments, in-line assessments, and final examination.
The program has been designed in association with the Irish Institute of Industrial Engineers, the Canadian Professional Logistics Institute, Lean Experts, and Healthcare Consultants in conjunction with the Leading Edge Group. It is open to personnel involved in any organization within the healthcare field, particularly those associated with hospitals, clinics, nursing homes, blood banks, laboratories, and pharmacies. Once these people have the ‘appropriate’ knowledge, they will be able to envisage and achieve results and, most importantly, meet the needs of patients now and in the future.