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 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.