Power of Lean Healthcare
As healthcare costs increase at a faster rate than other products or services, healthcare 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:
o Redundant capture of information on admission
o Multiple recording of patient information
o Excess supplies stored in multiple locations
o Excess time spent looking for charts
o Patient waiting rooms
o Excess time spent waiting for equipment, lab results, x-rays etc.
o 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
o Improved patient satisfaction
o Increased operating room utilization
o Reduced time between procedures
o Lower tools and supplies inventory
o Reduced laboratory space
o Improved cost effectiveness
Lean Healthcare Accreditation
A new Lean Healthcare Green Belt Certification program (www.leanhealthcareservices.com) 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.
Please contact Joe Aherne CPA, Chief Executive Officer, Leading Edge Group, jaherne@leadingedge.ie; www.leanscm.com; www.leanhealthcareservices.com
Joe Aherne
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April 19th, 2010 at 5:13 am
Help clarifying this health care bill stuff?
It’s hard to get a really clear picture with both sides contradicting each other. Like anti-bill people say it’s horrible the government is trying to gain more power, but yet it seems like a nice thing to do, helping people and trying to save lives in a sense. I’m trying to see ways that it would be bad if the government did have more power regarding healthcare, like how that could hurt us down the line. Insurance companies/policies can already be horrible, so is it just that people think it’s going to open doors for them controlling more aspects of our lives? But then I think about all the surveilance that is now put on Americans (after terrorist stuff) and there didn’t seem to be as much uproar about that. Wouldn’t it be the same argument, of the gov’t wants to protect/help us, so butting in and using their power is ok? Also one side says this costs way too much, whereas others say it will reduce the deficit greatly in 10 years or something like that. Plus I hear a lot of people mentioning the cost of medical bills for those insured. Like they raise the cost for the insured to make up for treating all those people without insurance so it’s like we already pay for the uninsured. Obviously I am leaning more pro healthcare, but I do want to better understand why people are against it and see their side of it. It’s hard having a discussion with some people I know that just say it’s bad, democrats are evil etc, etc. I need more educated answers besides "just because" lol.
April 19th, 2010 at 10:15 am
i think they should get rid of state run health care altogether, but i guess you cant have your cake and eat it too
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April 19th, 2010 at 10:17 am
Universal health care is a "nice thing to do" as you say, but the argument starts with who is going to pay. Conservatives and Republicans do not believe charity is the government’s job because for the government to pay for this, they have to tax someone else. In a sense its like forcing people to give charity instead of having people make their own decision. They very much believe and defend voluntary charity.
Liberals support single-payer health care, meaning that the government covers every citizen automatically and there is no more private insurance companies. Taxes would be needed to pay for this type of system. President Clinton attempted to impose a single-payer system in 1993 and the American people nearly revolted. The Democratic Party lost the majority of Congress for the next sixteen years.
President Obama has tried to compromise between liberals and conservatives. He supported a public option, which would be like a single-payer government plan, but one that would still compete with private insurance companies. Conservatives opposed this, too, but this was actually the best of all compromises. Free market capitalism continues for private companies, but the government provides charity for the less advantaged (no different than popular programs such as Medicare and Medicaid).
But this compromise did not satisfy Republicans. They were able to have the public option dropped from the bill, but the mandate was kept. The mandate requires every citizen to buy health insurance, even if they don’t want it or can afford it. Conservatives argue that this violates the principles the U.S. was founded on because it denies people the freedom to make their own choice. Also without a public option, people who can’t afford insurance still have to buy it from a private insurer. This compromise satisfies no one.
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