I found this article about the Saskatchewan Ministry of Health and how they are making dramatic improvements in the delivery of patient care. I am proud when I read this article because I was one of the lean consultants that delivered the lean training to the medical staff in several hospitals throughout Saskatchewan.

Lean Healthcare Improving The Patient’s Experience

Lean Healthcare Transformation

Saskatchewan’s Ministry of Health is in the midst of an ambitious plan to alter the way it strategizes and delivers health care across the province.

If it is successful, the province will be the first in Canada to introduce the so-called “Lean” system of management to all of its 43,000-plus health care workers and managers.

Dan Florizone, deputy minister of health, calls the approach a “game changer” and says Lean has the potential to “turn the system on its head.” He says the 50-year project will include everyone from the nurse practitioner in a remote northern clinic to dozenmember teams in big-city operating rooms.

“This is transformational,” Florizone said. “No state or province that I’m aware of in the world has attempted it on this scale.”

In 2008, Florizone was recruited to the ministry from his post as CEO of the Five Hills Health Region in Moose Jaw, largely to lead the introduction of Lean across the provincial health system.

He’d already been doing just that in Five Hills, which acted as a test site for the province’s early dabbling in the philosophy. Pilot projects in that region reduced injuries and eliminated a backlog of jobs for maintenance workers, squeezed in more colonoscopies without increasing spending and juggled supply carts to cut down time professionals spent doing inventory counts.

A last-minute redesign of the Moose Jaw Union Hospital’s ER has also paid off. In a recent Health Quality Council survey of emergency room patients, respondents gave that hospital some of the best ratings in the province for waiting times and quality of care from health care workers.

Pioneered by Toyota, Lean methods have since been embraced by players in the manufacturing and service sectors.

The cru To look at a product or service from a customer’s perspective and identify waste, or aspects a customer wouldn’t pay for by choice. Defective products, waiting or walking back and forth to see different health care workers have no value in the eyes of consumers.

Eliminating waste every time a step is repeated can add up to significant gains, according to the philosophy. And, the ideas about what constitutes waste have to come from the front lines – in this case, health care workers, patients and their families.

Florizone admits he was skeptical until he participated in a workshop at Seattle’s Virginia Mason Medical Centre in 2004.

“It’s going to take a hell of a lot of leadership to be able to convince people this isn’t a fad,” Florizone said. “There’s only one way to convince the skeptic and that’s the way I was convinced – let’s do it.”

It is a mistake to think health care is so different from other industries that it can’t use the same solutions manufacturers have already found to similar problems, Florizone says.

“The old way of cost-cutting was absolutely wrongheaded,” he said. “I realized for the first time why we were so mistaken in the ’80s and ’90s when we were cutting budgets and ending up with poor service at the end of the day.”

Deciding what to tackle is another key component of Lean. Florizone says an organization needs to pick just a couple of top priorities and focus intensely on them before moving on to the rest of its wish list. “If everything’s a priority, nothing’s a priority.”

The government has organized Lean’s provincial rollout into two phases.

The planning phase is called Hoshin Kanri in the original Japanese term. The government is calling it “strategy deployment.”

It differs like this from current strategic planning: High-level executives run their proposed priorities before teams of lower-level managers and front-line workers, then consider their feedback before proceeding.

Phase 2 will take several years and involves building up local expertise and getting more than 43,000 workers in the province’s health regions, Saskatchewan Cancer Agency, Health Quality Council and Health Ministry thinking like a synchronized Lean machine: Identify waste, test a possible fix, evaluate the outcome and repeat. The cycle can, and should, go on forever. View the original article.

This article is a testament to the hard work of the people involved in this healthcare improvement project.  Not all people start off as a believer or convinced that a new process will work. However, the Saskatchewan Ministry of Health has proven that they can deliver believable results . They have clearly answered the core question that many people ask: Is lean healthcare improving the patient’s experience? The answer is “Yes, it is.”

Healthcare waiting times and costs are being reduced. Hospitals systems are becoming patient centric, which makes them more “patient friendly.” Lean principles are giving medical staff the ability to learn how to “work smarter,” which beats “working harder.”

Traditional hospitals are not designed for people, they are designed around processes.  Sick people are moved through a series of processes, which creates lots of  inefficiencies. In a traditional hospital  it is an accepted practice for  patients sitting in waiting rooms. A Lean Healthcare model does not accept this practice and they find ways to eliminate or reduce the amount of time that a patient has to wait for the next available nurse or physician.

In this article, I bring your attention to the application of lean principles taken from the Toyota Production System (TPS) and how they are being implemented into healthcare organizations to improve patient care.

Lean Healthcare Transformation

Lean Healthcare Transformation

Japanese vehicle manufacturer, Toyota, is well-known for developing the principles of so-called “lean manufacturing”. Research published in the International Journal of Technology Management suggests that the lean approach might also be beneficial to medical procedures, making hospitals more efficient and cut waiting lists.

Management Engineer Kasper Edwards of the Technical University of Denmark in Lyngby and colleagues first reviewed the research literature on lean practices. Lean manufacturing based on the Toyota Production System is founded on the idea of “preserving value with less work”. It is perhaps the natural extension of the Ford Motor Company’s original production line approach and involves avoiding any expenditure or costs that do not create value for the end customer. From the consumer perspective, this means offering products or services at a price the customer is willing to pay.

The team hoped to discover whether the same values of lean, value and efficiency might be applied to healthcare systems. Their research demonstrates that within the Danish public healthcare system, “lean” can work very effectively for some parts of healthcare provision, such as surgical wards but not necessarily for others. Lean could thus help address the problem of not only financial constraints on public health services but also help hospitals cope with the problem of a lack of doctors, nurses and healthcare professionals in general.

The researchers point out that until recently, lean projects in healthcare have focused only on peripheral activities to improve patient flow through wards and reduction of turnover times. Numerous hospitals have implemented lean in these contexts with varying degrees of success. Likewise, administrative procedures have also benefited from a lean approach. The team has now studied the case of a major hospital outside Copenhagen with 200 employees and ten operating rooms. Surgery was split into two streams: one following normal procedures, the other running “lean” for elective operations. Ultimately, the program was initiated to create more effective working procedures, and ensure a total continuity of care to the benefit of both staff and patients in the light of absenteeism and morale problems at the hospital. View the original article.

In a world with an aging population, the only way that hospitals are going to be able to meet the growing demand is by going through a Lean Healthcare Transformation. Medical staff need to receive training to allow them to understand that lean principles demonstrate how to work smarter, not harder. Throwing more money or adding people into an already inefficient system is not going to meet the challenges of the 21st century healthcare organization.

Featured image by: Sura Nualpradid

Lean Methodology in Health Care Quality Improvement | Mental Illness

Its principles and practices also have been applied to health care organizations with success. This has been accomplished with refinement for the nuances of health care. Lean is a process management philosophy which has … read original article

This is a great article that demonstrates just how powerful lean methods are when they are applied in the right way, at the right time, for the right reasons.

There has been lots of talk over the years about the benefits of implementing principles from the Toyota Production System into a business system.

However, the healthcare industry is now implementing the same lean principles developed in the manufacturing sector. As a result of using lean principles they are improving the delivery of services to patients. Healthcare costs can be reduced using the same lean tools as Toyota uses to build cars. Why is this so important?

It’s important because anyone purchasing a health insurance plan is paying more than at any previous time. These premiums are climbing much faster than personal incomes The United States is paying out more money per capita on healthcare than any of the other OECD developed countries. Almost all OECD countries have seen an increase in their healthcare spending as a percentage of their gross domestic product (GDP). According to data compiled by the Organization of Economic Cooperation and Development (OECD) the USA share of GDP devoted to healthcare grew from 8.8% of GDP in 1980 to 15.2% of GDP in 2003.

The Congressional Budget Office (CBO) put the percentage of GDP on health care at about 16% in 2009 which converts into hard cash of about $1.3 trillion compared to around $75 billion in 1971. The Congressional Budget Office has estimated this percentage will almost double to 31% of GDP over the next 25 years in the United States. This increase will have a serious impact on the economy in the United States because health care spending will continue to increase at a faster rate than incomes. In 2009 US consumers were spending an average of $7,290 per person compared to $2,964 per person in all other OECD countries. This data demonstrates the disparity between higher costs versus the quality of healthcare in the United States compared to what other OECD countries are paying for what appears to be a better quality of service. What can be done to help reduce the impact of this problem?

Which Lean Tools will work best?

Step 1 to implementing Lean Tools?

Teaching healthcare workers to understand the application of lean principles and how they can be use lean tools to discover and remove waste is the first step. Getting them to make the connection between waste and increasing costs is very important. Everyone needs to understand that lean tools are used for the removal of non-value added activities (waste) will improve patient satisfaction, while reducing costs and increase profits.

Step 2 to implementing Lean Tools?

The second step is to train a team about Value Stream Mapping so they can define and understand where there are constraints in their healthcare facility. Training in how to use VSM, which is one of the lean tools, will get everyone to focus on the same things and allow them to develop the common language of lean practices.

Step 3 to implementing Lean Tools?

The third step is to teach every worker in a healthcare facility to use lean tools to become a problem solver. Understanding and applying one of the most important lean tools, which is the 8 step problem solving model from the A3 process using PDCA (Plan, Do, Check, Act) or PDSA (Plan, Do, Study, Act). This will help them see how lean tools can focus them to discover and remove the root causes of problems.
Implementing these three easy steps to implelement lean tools can launch any healthcare organization on the path to continuous process improvement by reducing costs, while improving the level of client or patient care. To learn more about lean tools click here