The term Lean is often followed by the term manufacturing, since that’s where the idea first took root. So it’s natural that many people—maybe most people—outside of manufacturing aren’t aware of Lean methods.
If you aren’t familiar with Lean, it is what I like to call an organizational lifestyle change. Just as a commitment to good health requires a person to adopt a lifelong goal of exercise and healthy eating habits, Lean requires an entire organization to buy into its approach.
There are three basic goals of Lean.
• Focus on providing the best possible customer experience
• Minimize waste in the development/delivery of goods and or services
• Continually strive to improve in all areas
But will Lean principles work in non-manufacturing endeavors? For example, does Lean work in healthcare?
The overwhelming evidence says the answers to these questions are yes and absolutely, yes. Applying the above ideals of Lean to healthcare, we get a goals cycle diagram that looks like this:
Does Lean Work in Healthcare? These Case Studies Say it Does
Here are just a few case studies, with links to the stories, validating how Lean does work in healthcare.
Banner Health – Doctors and nurses teamed to improve emergency room processes and reduce litigation risks. The result was an 89 percent decline in patient complaints prior to discharge.
Moffitt Cancer Center & Research Institute – Increased procedural volume by 12 percent and added nearly $8 million to its annual incremental margin.
St Joseph’s Hospital – By using Lean to change its patient flow in the ER, is able to treat at least 10,000 additional patients annually. This will add up to $8 million to its bottom line.
New York City Health and Hospitals Corp – Cut a $10 million inventory in supplies, many of which would expire unused, by switching to a just-in-time inventory system. Inventory was cut in half for a one-time windfall of $5 million.
Delnor Hospital – Implementing a Lean system, the average length of a patient’s stay was cut by 10 hours. This made a contemplated $80 million expansion unnecessary.
ThedaCare – This operator of multiple hospitals and clinics slashed inpatient care costs by 25 percent. The improved productivity and savings on supplies saved the organization $27 million over four years.
That Sounds Great. So How Do I Use Lean to Improve My Healthcare Practice?
The first step is to take an honest assessment of your current processes. In Lean terms, this is called your value stream. You want to do this from the patient’s perspective. The best way to do this is to create a value stream map. This short video helps to explain how to create a value stream map.
Next, you will examine your current state to assess areas of waste. For example, long patient waiting times, paperwork bottlenecks, communication gaps or even inventory control issues.
Data will be collected to determine how much time is spent in each step. Specifically, you’ll be looking to break time into two elements: value add time (this is the time that adds value within the process, such as examining a patient) and non-value add time (time the patient wastes waiting to see the doctor or time wasted by admin staff trying to locate patient files, for example).
Once all of the data are gathered and the current state map is complete, a future state value stream map will be created. The goal will be to take the practice from where it currently exists to this future, Lean state.
Obviously, this is an oversimplification, but hopefully you get the idea. By focusing on making every step in the various processes of your practice more effective and efficient, and by focusing the entire organization’s efforts on maximizing the patient’s experience, everyone benefits.