What is Lean?
Lean is a way of thinking of about a process that aims to identify and eliminate waste. This focus creates value for the customer. Lean is also a management system that addresses accountability and communication within a team. This is done with the intent on making the issues affecting a team transparent and addressing them together. The strength of a team is in its members, and that truth holds true when trying to improve a process.
A Few Ways to Start Out with Lean
Take a look at the patient experience from the patient’s perspective. A value stream map will provide a comprehensive view of how the patient flows through your clinic and derives value from the experience. It provides the user with a high level view of not only the patient flow, but also the different types of information and material flows used to complete the patient visit. This is a good starting point used by many to identify any one of the 8 wastes of Lean.
Use the 8 wastes of Lean, (Defects, Overprocessing, Waiting, Not Using the Appropriate Talent Level, Transportation, Inventory, Motion, Extraprocessing), to identify areas that experience these wastes. Use tracking tools to identify how frequently they occur and go after the most prevalent waste first using your daily management system to track progress.
Identify the pieces of the current value stream to be modified in order to achieve the desired future state value stream map. Using a prioritization method, have the team collectively decide which items are most critical and impactful to achieving the future state. Then develop an action plan for the team to execute over the next 30, 60 and 90 days.
An effective daily management system creates the personal motivation to make change happen. It does this by engaging the employee base in the act of problem solving. The daily management system is a collection of tools used to facilitate a daily discussion around lean application in healthcare.
Lean Process in Healthcare
Improving a Surgery Department
For a couple of years now I have heard about and witnessed (via friends in the industry) the consolidation of resources in the oil & gas industry through layoffs and closures. This activity was due to a push to flood the market, driving down prices, and in turn causing turmoil. On the drive in this morning, I heard a news report about how the Texas oil & gas industry had brought major international players in this space to a stand still. When they flooded the market, the ingenuity of these American organizations responded by developing cheaper ways to produce their product.
When the main driver of revenue was threatened by oversupply, the free market system responded with innovation.
There is an analogy here to the healthcare industry and it begins in the surgery suites of your typical hospital. The value stream that takes the patient through the process of surgery in a hospital is a main revenue driver. A main competitor of hospital operating rooms, Ambulatory Surgery Centers (ASCs) provide outpatient surgery services for patients at a reduced cost without the added expense or length of stay of a typical hospital surgical stay. ASCs typically operate at a higher efficiency than an acute care hospital operating room. To get more out of their value stream, hospital operating have had to innovate and change to meet these market demands. In my experience, hospital surgical suites can carry significant opportunity to identify and eliminate existing waste in key processes using lean.
Some common areas to look for lean waste in a surgical department include:
- Pre-operative (pre-op) process
- Supply & Inventory process
- Scheduling Process
Improving a Hospital Housekeeping Department
Healthcare is complex. There are many pressures competing against any organization succeeding in providing a good patient experience; let alone a great one.
In my time as a health system executive with oversight for a multi-facility housekeeping operation, I can tell you that this is very true in the world of hospital cleanliness. There are many, many challenges to providing an excellent level of service that’ll make the patient and their families feel like they are being cared for in a clean environment. The list is long: staffing issues, technique variation, high turnover, supply chain hiccups, unexpected equipment outages, supply leakage, etc.
The importance of a well-run housekeeping system can not be overlooked. This function is essential to the patient experience. It can have a significant impact on other facets of the patients exposure to the organization. I had one executive recount a story of his first stop as a CEO and how the housekeepers planned a strike. He said, “I found myself with a potential strike from the housekeepers in my facility and knew that it had to be fixed. A hospital can’t run without a housekeeping department.”
The good news is the application of lean process in healthcare works in this type of operation. There are multiple opportunities to apply these methods and systematic approach to the management of a large or small housekeeping organization.
More About Me
My name is James Hearn. I am passionate about improving processes and creating value for leaders and their teams.
This website is about my experience with lean process in healthcare. You will also see posts about other topics of interest related to the healthcare industry. I want to share my experience with the reader through blog posts, video log posts, resource links and tool reviews. My desire is that this site will be a resource for you as you explore lean application in healthcare.
James C. Hearn, MHA