Sunday, November 2, 2014

Lean Thinking: COPD Readmission

Lean thinking, or lean manufacturing, is a method which focuses on reducing waste. While this sounds simple on the exterior, reducing waste in any company is accompanied by a long process. Although the process of this lean manufacturing may be extensive, the payoff is usually great, as we have seen in the article discussing Children's Hospital in Seattle. After reading about the different frameworks of lean manufacturing, six sigma and theory of constraints, the lean thinking stood out as a method that would be most practical in companies of every sector. With this said, I was interested in viewing this method viewed more in the healthcare sector and in what ways it has improved the process or made it worse.

As stated in the NY Times article, healthcare is hard to standardize because no patient is the same. Thus, finding a standard process to reduce waste is challenging for this sector. However, applying lean methods in healthcare could eliminate waste and make patient outcomes better. In an article titled Applying Best Practice in COPD, UPMC of Pittsburgh worked to reduce the number of readmissions of COPD patients by 40%. In doing so, UPMC and PRHI called upon Healthcare Performance Partners (HPP) to apply lean methods in healthcare.

Initial discoveries brought forth the issue that most patients did not know how to properly use their inhalers, which is a simple task to educate. On the backbone of this problem was miscommunication between staff, where one thought the other was educating the patients. With this, the hospital was worried that they would need to hire more full-time staff to take over this job. However, with lean methods, the hospital was able to reduce the expected amount of full-time employees by standardizing other equipment and methods and working in real-time. This is just one example the article offers with lean management in healthcare. By reducing the amount of readmissions, UPMC was able to focus on other areas and reduce costs that would normally be used on the patients coming back in for COPD.

I think lean thinking can be adopted in a variety of organizations and sectors. I believe the healthcare sector would benefit greatly from this thinking with the current overwhelming costs associated with it. If management could reduce waste and make the health sector more standardized, the costs of healthcare could have the chance of decreasing, as we have seen with the examples from Seattle and the decreased readmissions of UPMC. If these patterns remain consistent, the healthcare field could be on it's way to reducing costs and providing better patient outcomes.


Question: After viewing these articles and noticing these methods have not been widely adopted in the healthcare industry, is this lack of adoption due to staff resistance? Or is there not enough evidence and too much risk for hospitals to try this thinking?

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