Monday, September 8, 2014

Improving Healthcare using Lean Technology

“Operation management is dealing with how the work is organized, managed, analyzed and carried out.” It involves process mapping to identify the bottlenecks and reduce inefficiencies in the system. Many techniques such as six sigma and lean methodology deal with process improvement in various systems.

Lean is not a quality improvement tool, program or a quick fix. Lean is a “cultural transformation” that redesigns the way the organization functions. It requires changes in the working pattern of the entire organization right from senior management to the front line managers. Lean methodology is being used in the field of healthcare to improve efficiency and the quality of care. Using the given principles many healthcare facilities can be improved:

·         Lean is an attitude of continuous improvement
      The PDSA (Plan Do Study Act) is a core principle for lean which focuses on continuously improving the process. Senior management must give the decision making control in the hands of the front line managers as they are closest to the problem. Continuous training, encouragement and time should be given to the clinical and on clinical staff. [1]

·         Lean is value creating
The healthcare facilities should focus on creating monetary as well as non-monetary value for their patients. Faster response times, fewer medical errors, following operation schedules and increasing the overall experience should be the goal of the healthcare facilities.[1]

·         Lean is unity of purpose
Lean specifies the priorities to achieve the desired goal. The steps of the process should be clearly defined to reduce error. In one of the healthcare clinics, visual boards were kept outside the rooms of patients on ventilators. Flipping the red and green magnets every two hours on the board allowed the care provider to determine if any preventive measure was missed.[1]

·         Lean is respect for the people who do the work
Unlike other hierarchical settings, in Lean it is important that the senior management trust and support the front line managers. ‘Gemba’ is a Japanese word that stands for the place where work happens. Senior management support the front line workers by continuously visiting the plant, understanding their problems and barriers to proposed solutions.[1]

·         Lean is visual
Visual tracking centers are found in most areas in healthcare facilities. Charts, Sticky notes and labels helps the employees get a quick overview of the current scenario. IN one of the hospitals, the inventory unit was managed using color coded labels to determine when a unit was out of stock. Adequate supply was indicated by green, yellow indicated replenishing was needed and red indicated that there was an immediate need for restocking. [1]

One example of efficient Lean implementation in a healthcare facility is of Thomas Jefferson University Hospital. It is an acute care facility in Philadelphia which has nearly 50,000 admission and 120,000 emergency department visits each year. They used lean methodology to improve their responsiveness and customer service. Interview were conducted and all the people from senior management to staff level were trained and involved in the process. They underwent a comprehensive process which included validating the current state, prioritizing tasks, removing barriers to solutions, creating future state design and incremental improvement plan to achieve it over time. As a result of the implementation they were able to achieve sustainable gains and quality improvement. [2]

Lean is an innovative management and process improvement strategy which can help reduce costs without compromising on the quality of care in healthcare facilities. Although lean methodologies have various benefits there is a debate on some its disadvantages as well. Lean methods are used to improve employee utilization and this can discourage them. Many medical practitioners feel that all patients are different, hence the time taken to perform the same procedure on different patients cannot be standardized. They resist lean methodology as they feel that cutting corners to improve efficiency compromises the quality of care. Hence, the question arises as to whether the benefits of lean methodology justify certain risks in its adoption?

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