Monday, September 16, 2013

Resistance with Implementing Lean Methodologies in Health Care

Lean manufacturing has been used in the automotive industry for more than 50 years.  However, it was not until recently that lean methods have been adopted by other industries such as health care.  The Toyota Way is based on streamlining process flow, reducing overproduction, decreasing inventories, and reducing costs throughout the entire process.  In health care, there is plenty of room to decrease wasteful spending and delays in the care delivery process.  The Julia Weed article, "Factory Efficiency Comes to the Hospital" did a great job of illustrating the potential savings the hospitals could realize by adopting lean processes.

A brief paragraph in the Weed article mentions that Nellie Munn, an RN at Children's Hospital in Minneapolis believes these changes are inappropriate.  She things that her daily activities should not be timed out and standardized because some patients require more personal interaction.  This belief is shared by many providers in hospitals throughout the US.

 I spent this past summer working on a process improvement project at Children's Hospital of Pittsburgh.  My job was to map the process flows for each ambulatory clinic at the Lawrenceville campus, track the flow time of each activity, and identify activities that could be changed or removed to decrease patient wait time and overall length of visit.  I spent the first two weeks interviewing physicians, nurses, and staff working in the ambulatory clinics.  I received mixed feelings from workers after explaining the purpose of my project.  Most of staff members liked the idea of streamlining activities to help reduce stress that the bottlenecks put on them.  About half of the physicians were also on board and actually believed that doing so would allow the quality of care to increase.  Most nurses however were not enthused with using data driven observations to reconstruct the patient visit.  Their general concern was that setting a standard work time for a given activity would rush nurses when caring for a patient who required more than just the textbook definition of their care/treatment.

I believe that this is the biggest opponent to widespread adoption of lean procedures in hospital settings.  To be successful, it needs to be realized that adopting this changes is not as simple as copying and pasting.

What challenges have other industries faced when adopting lean strategies from the automotive industry?

This article explains how some lean methodologies can be implemented in health care:

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