Lean healthcare


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  • due to Lean interventions ideally should encompass a benefits vs burdens effect on all affected stakeholders.
  • Lean healthcare

    1. 1. Lean Healthcare
    2. 2. Lean Management • Definition of Lean – a quality improvement philosophy and set of principles originated by the Toyota Motor Company. – Lean In Healthcare • An organization’ s cultural commitment to applying the scientific method to designing, performing, and continuously improving the work delivered by teams of people, leading to measurably better value for patients and other stakeholders. • Transforms how an organization works and creates an insatiable quest for improvement.
    3. 3. Lean Healthcare Principles – Attitude of continuous improvement – value creation – unity of purpose – respect for front-line workers – visual tracking – flexible regimentation
    4. 4. Attitude of Continuous Improvement • The Deming Cycle – Plan-Do-Study-Act (PDSA) – central tenet of Lean. • Transform Culture – senior management must relinquish the role of master problem solver to those who are closer to the problems to be solved • Lean uses basic approach of measuring whether new process is superior to existing process. • Uses rapid improvement event leads to changes – a staff huddles every morning to monitor and discuss the metrics • • • • wait time Call volume Dropped call rate among other topics.
    5. 5. Value Creation • Improve value for patients – – – – – – Fewer medication errors fewer nosocomial infections less nursing time away from the bedside faster operating room turnover time improved care team communication about patients faster response time for emergent cases • Benefits – – – – – – patients Physicians Nurses healthcare organizations Payers Community
    6. 6. Cont. Value Creation • Value in health care has been conceptualized as health outcomes per dollar spent • value more broadly as benefits received for burdens endured – Monetary costs – Nonmonetary costs.
    7. 7. Cont. Value Creation • Benefits vs Burdens – Conceptualization of value • medical outcomes • financial costs • Extends – patients’ perceptions of the overall healthcare experience • Measuring improvement in processes – Questions that robust Lean measurement should answer • Who is affected by the changed processes and in what ways? • Do benefits increase? • Do burdens decrease?
    8. 8. Cont. Value Creation • Value stream maps are a principal Lean tool used to distinguish between discrete steps in a process that do or do not contribute value
    9. 9. Unity of Purpose • clarifies priorities and guides staff in improvement work accordingly. • Focused Work • Priorities govern investment of improvement resources. • Prioritize and clearly communicate a small number of strategic goal categories relevant throughout the organization • Have the most promise to strengthen the organization • Create stakeholder value.
    10. 10. Cont. Unity of Purpose • Projects fit within this strategic framework • Specific improvement projects (the “ how” ) • Move the organization forward in its prioritized goal categories (the “ what” ) • Management uses a process called catchball – Communication back and forth in the organization builds consensus, understanding, and engagement around the priorities
    11. 11. Respect for Front-line Workers • leadership upside down, with front-line workers doing much of the innovating and managers trusting them to do it and supporting them • front-line workers to have the brainpower and commitment to improve the work must pervade the organization • Respect flows downward, not just upward.
    12. 12. Cont. Respect for Front-line Workers • Management must make special efforts to create a safe environment for innovation • Attacking processes rather than people so that staff members do not fear reporting problems
    13. 13. VisualTracking • information displays mounted on the walls in staff-only areas • information is dynamic and directly relates to what staff are thinking about in terms of how best to provide what patients need and want • The value stream maps helped prioritize design requirements that contributed to the facility being built
    14. 14. Flexible Regimentation • Processes are perfectly designed to produce the results that occur • key to improvement is determining the root cause (or causes) of performance shortfalls and ridding the process of the cause(s) through redesign. • Take nonstandard work processes and transform them into standard processes that improve performance and then continue to improve the standard work design through PDSA
    15. 15. Final Note • Lean is an innovative management approach that has proven successful in health care organizations. • It offers promise for improving quality and efficiency while controlling costs in the provision of optimum patient care. • To implement the Lean philosophy and principles, however, is to undertake an arduous, never-ending improvement journey. • Because Lean transforms organizational culture from the inside out, it offers both challenges and opportunities. • It requires a major shift in roles: – managers and leaders must become facilitators – mentors, and teachers and allow front-line workers to make improvements. – It engages the entire staff in identifying and solving problems based on a continuous improvement attitude, the driving force behind Lean work.
    16. 16. References Bell, S. C., & Orzen, M. A. (2011). Enabling and Sustaining Your Lean Transformation. Director (p. 349). CRC Press. Clark, D. M., Silvester, K., & Knowles, S. (2013). Lean management systems: creating a culture of continuous quality improvement. Journal of clinical pathology, 66(8), 638–43. doi:10.1136/jclinpath-2013-201553 Toussaint, J. S., & Berry, L. L. (2013). The promise of Lean in health care. Mayo Clinic proceedings. Mayo Clinic, 88(1), 74–82. doi:10.1016/j.mayocp.2012.07.025 Womack, J. P., & Jones, D. T. (2005). Lean consumption. Harvard business review, 83(3), 58– 68, 148. doi:10.1049/me:20050411 Womack, J. P., Jones, D. T., & Roos, D. (1990). The Machine that Changed the World: The Story of Lean Production. World (pp. 1–11). Harper Collins. Yazdani, B. (1995). Toyota production system: An integrated approach to Just-In-Time. Computer Integrated Manufacturing Systems. doi:10.1016/0951-5240(95)90010-1