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VIPGroup
Lean Healthcare
There's a lot of excitement today in Health Care about the
benefits that Lean can bring. Healthcare services are complex
processes which involve diverse professional skills, varying
patient needs with cutting edge technologies. Variation and
Non-value added activities are inherent on the process. A high
degree of both makes it challenging to anticipate and manage
results. Variation and Non-value added activities also lead
to patient dissatisfaction which in turn drives up costs, further
convoluting the system. If you can reduce variation and Non-value
added activities in a process, you can significantly reduce
the amount of unacceptable outcomes or "defects" in
the process. Eliminating defects one at a time or in
quantity greatly increases the level of efficiency, profitability
and the patient experience. This is especially critical in an
environment where patient needs are increasing while the pool
of skilled resources and reimbursement for services are dwindling.
The key is to apply Lean
Healthcare concepts in a regulated environment driven by
the unique values that surround patient care.
As a strategy, cost savings is limited because large cost savings
are usually taken early, making further savings more difficult
to capture. In addition, cuts are usually made in the
value-added areas (people, equipment, beds, services, etc.)
which reduce the quality of the experience to the patient.
Applying manufacturing tools and techniques may seem counterintuitive
or even outlandish to the healthcare professional, but as other
industries have learned, it is not the tool per say, but the
concept behind the tools that is important. Many hospitals have
already jumped into the arena with six sigma efforts. Interestingly
enough most report little to no benefit and some have even abandoned
the idea all together. Why? The following list captures the
main reasons:
- Lack of support from senior or middle management
- No corporate structure to deploy and monitor change
- Outdated or weak VOC data (Voice of the Customer) both internal
and external
- No corporate strategy to deploy
- Weak communications systems
- No corporate ownership of the program
- No mechanism for transfer of knowledge, best practice sharing
or sustainability.
- Metrics for success
- Lack of dedicated resources
No wonder change effort fails, without these CSF's (critical
success factors) in place companies should expect to fail not
succeed. While some providers do in fact have some of these
CSF's in place many do not. Clearly, they have all read
the wonderfully inspiring books from GE, Motorola, and others
describing unprecedented success and rewards. What they missed
was the how, what, where and when of the success… the
strategy, the deployment and the execution
. Compared to the manufacturing and service
industries, the performance management process in healthcare
is far behind. In other words, although doctors are able
to cure and prevent a wider range of illnesses and provide more
comfort, the cost, quality and delivery of the health service
has essentially not improved significantly, in fact the chasms
seems to being widening.
Healthcare has a tremendous opportunity to deploy Lean Healthcare
concepts to reduce internal/external costs, improve patient
safety, increase profits, reduce litigation and decrease the
dependence on Government and Insurance. To accomplish this monumental
task, Healthcare providers will need to turn the microscope
inside and do what others, Toyota , Dell, WalMart and the like
have done to be best-in-class. Lean applies to all areas of
any industry especially Healthcare.
As in other industries, we can all agree that the customer
should come first. In healthcare that customer is the patient,
the regulatory bodies and maybe even the Insurers. They all
define and drive the definition of value (i.e. what is not adding
value to their needs). The product (Laboratory results) or service
(patient care) can make the difference between life and death.
The needs of the patient are paramount and give new meaning
to Lean Healthcare. This then makes Lean even more important
in this industry over manufacturing or other services.
Today healthcare is not designed to make the value stream of
care flow smoothly . As with manufacturing, healthcare services
are often “batch and queue”, with patients spending most of
their time waiting until the right process (skilled healthcare
practitioner) is available. As a result, the value added
processes are disconnected leaving the patient and the caregiver
all disillusioned. The working environment is one driven by
shared values and passion in delivering top quality products
and services to the patient. Without Lean, healthcare will continue
to have difficulty meeting the pressure to serve an increasing
number of individuals at less cost. As the population ages,
healthcare must find new ways to meet the demand for their services.
Turnaround time (i.e. patient cycle time, service Takt time)
becomes a primary measurement that must improve whether it is
in the hospital facilities, post care facilities or laboratories.
Further, space is at a critical premium in running all the functions
within a hospital facility. Only Lean can provide a solution
to all these concerns with minimal expenditures but maximum
benefits.
There is one caveat, Lean can assist healthcare providers in
reducing costs, improving service levels and increasing value
but must do so without compromising quality of care, compliance,
brand, patient safety, or conformance. This is the challenge…the
opportunity. Health Care professionals are surprised to see
similarities with other industries when they actually look at
the benefits of applying Process Excellence methods in their
environment. Once they have the 'right' knowledge they are able
to see and achieve results which meet the needs of patients
now and in the future.
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