Saturday, September 15, 2012

Going Lean at ThedaCare

ThedaCare, a Wisconsin-based medical system with four hospitals and numerous clinics, has been applying lean manufacturing to its processes since 2003.  In a 2009 Health Affairs article entitled “Writing the New Playbook For U.S. Healthcare: Lessons from Wisconsin," author John Toussaint details how ThedaCare has been able to implement procedures that borrow from the famous Toyota Production System. The result has been less waste (supplies, staff time, unnecessary patient hospitalization time) and therefore money saved. Toussaint specifically focuses in U.S. taxpayer dollars in the context of healthcare policy. Perhaps more importantly, the medical system has also been able to improve patient outcomes, such as reducing the number of pre-term births and length of time spent in the neonatal intensive care unit for those babies who were born early.

Theta Care has been so successful in this approach they are now sharing their industry experience. In one preview video, senior staff explains how strategy deployment is a key component of the lean approach. Strategy deployment is a method of management that allows for feedback loops between the top of the organization down to the front line service providers. It allows for information to cycle back up to the strategy level for continuous collaborative process improvement.

Their model involves senior leadership passing priorities to the next tier of management. This team then makes the goals actionable at the various clinics and departments within ThedaCare hospitals. Next, the “improvement opportunity center” translates the goals into procedures to empower staff, such as ICU nurses, to make daily improvements. Finally, staff educators in different departments conduct trainings to reinforce the key priorities. By narrowing the focus on 3 or 4 top initiatives, senior leadership is better able to pass information and organizational values down through the ranks connecting over 5,400 employees. The standardized focus of lean manufacturing is not always an easy fit to the highly variable nature of patient medical care delivery, but ThedaCare has been successfully adapting these best practices in a way that saves money, involves staff from all levels of the organization, and incorporates patient feedback and health outcomes. 

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