Lean Methodology In Health Care

In healthcare, throughput refers to the ED process that impacts patient flow (Jarousse 2011). Process and flow began to be scrutinized for opportunities to improve the overcrowding by becoming more efficient. Due to this new process focus, throughput was born. This is also the point where lean flow or lean thinking became prevalent into healthcare from a manufacturing stand point to improve throughput. Lean principles revolve around removing non value added steps and standardizing work flow and processes. When applied aggressively hospital wide, lean principles can have a dramatic effect on productivity, cost, and quality. Numerous books concerning lean healthcare have been published in recent years (Crane & Noon 2011).

Training Topic: The training topic purposed is, leader standard work, which is a lean tool that helps leaders to identify what is value-add and non-value-add in their work. Once a leader can identify what is non-value add, they begin to reduce the time spent completing these tasks and spend more time coaching their employees to problem solve and improve patient care. In lean value is determined by what the customer is willing to pay for. Consequently, in healthcare, the customer is the patient. Users of this tool do not have to be formal leaders within the organization, but the intent is to enable individuals to manage their daily, weekly, bi-weekly, and monthly activities strategically and to eliminate the the non-value add activities.

[20] cited (Miller, D., et. al., 2005).”“Adoption of Lean management strategies while not a simple task can help healthcare organizations improve processes and outcomes, reduce cost, and increase satisfaction among patients, providers and staff” . Balle [5] states that: “the adoption of lean in healthcare is very young it started in the late 90s but started to gain a little bit of momentum in the last decade and now in this decade many health organisations are looking at lean principles since it has been proven to be very successful in many cases around the world”.

A manager’s and leader’s role of mentoring, coaching, and facilitating is the key to the Lean process and the continuous quality improvement health care delivery requires. A change in management culture is required if lean is to have lasting success. Fortunately, Optum’s transplant services department is learning to apply lean management on a daily basis including the application of continuous quality improvement of the leader’s journey and the demands the industry presents, including taking time for critical

To facilitate quality improvement initiatives in Ontario, Health Quality Ontario (HQO) has developed a comprehensive Quality Improvement Framework (2013) that brings together several QI science models and methodologies including the Model for Improvement, as well as traditional manufacturing quality improvement methods such as Lean and Six Sigma. Health Quality Ontario grounded their framework in Deming’s System of Profound Knowledge to ensure that the suggested processes could be applied to any quality improvement initiative, in any health care sector. Health Quality Ontario’s QI Framework consists of six phases. Each of the phases is iterative and designed to build on knowledge gained in the previous phase. The phases are:

Table 3 shows characteristics of the seven key informants. Informants had an average continuous process improvement experience at least 22 years with majority of their health care experience being in large academic tertiary hospitals and military hospitals. All of the informants were formally trained in LSS and achieved the certification level of Master Black Belt. In Lean Six Sigma programs, the Master Black Belt certification level is the highest level attainable and symbolizes mastery of LSS topics and experiences in leading large-scale LSS process improvement projects (Gygi, Williams, & Covey, 2012). Key informants provided six common themes to barriers that impacts sustainability of LSS improvements in health care, and are explained below. These six themes were categorized further into two main topics: lack of leadership commitment to drive a culture of quality and inadequately trained and unqualified LSS practitioners to execute LSS projects in health care.

Quality improvement is a process, not an event. The fundamental aspects of quality improvement is that, quality is built in a process not added at the end of the process. This requires the involvement of management to support the initiative. In quality improvement the focus is on the setback of the system and in this case a theater checklist was implemented to ensure compliance to developed policies and procedures. All changes made were acceptable by the patients as the lean method was customer focus, and it has addressed the issues of patient safety (Elliott, McKinley and Fox, 2008). This reduced complaints and increased patients experience, satisfaction, hence improve morale of healthcare workers in PMH theatre.

It was considered to be overly structured and complicated, especially in the opinion of the CEO. He felt that lean management system enabled people’s involvement in the designing and improvement of processes more than that within the IT system. With the failure of initial IT implementation, CEO was of the opinion that “one size fits all” is not a feasible approach in Lean and IT amalgamation. Due to this, there were discrepancies of opinions among the executives as some believed IT systems could prove to be beneficial in the long run. Mr. Cremin believed that Lean manufacturing pushes the decisions down to people directly engaged in producing products. Incremented changes are key to innovation and continued improvement and an overly structured and complex IT system could interfere with the process innovation.

Healthcare providers strive to improve service quality by implementing various quality management programs. Customers tend to seek for higher quality of care when choosing treatments, providers, and health plans. For healthcare organizations that desire to provide high quality care and compete in the global market, choosing a quality management program to implement is critical for performance and efficiency. Many studies have been conducted to analyze the effectiveness of such programs. Lean, Six Sigma and Total Quality Management (TQM) are three programs that will reviewed by three different case studies in efforts to understand them and to compare and contrast their capabilities.

The healthcare industry could apply lean concepts and benefit greatly from its findings. Lean is a different way of thinking and acting for an organization that can really give them a competitive edge over competing organizations. I am not sure if there is really a competition going on between healthcare organizations, but it could also contribute to fewer incidents, accidents, reduced costs, and improved employee morale. Lean is not a program that the organization uses for a short term, but rather a different way of doing business that has long term, long lasting effects for the organization overall. This method can also lead to the overall satisfaction of the patients that, in simple terms, means a returning customer.

The lean principles motivates to achieve different benefits such as identifying values, map the value stream, create flow, establish pull and seek perfection. These principles can be applied in this case study as follows.

While lean thinking and principles have existed for a long period of time, many organizational leaders and people make lean mistakes basically because of some

The operational systems of organizations can be viewed as open systems, which interact with their respective environments on a continuous basis. In this context, these systems comprise synergetic and interdependent subsystems of input, process and output with the main objective of these systems being to efficiently and effectively deliver goods and/or services to their demanding customers (Yasin and Wafa, 2002). Confronting the challenges of global competition, companies have to reduce costs, improve quality, and meet their customers’ ever-changing needs (Canel et al., 2000). Even though lean techniques were developed for the manufacturing firms and

The main reason why organizations need to have a strategy to become lean is because of the changes inside their industry. This is occurring from increasing amounts of competition in the global marketplace. For many firms, this is forcing them to seek out ways to: continually innovate, meet customer demands and maximize profit margins. To achieve these objectives means: reducing costs dramatically and being the first to deliver the cutting edge products consumers want. Those firms that are able to achieve these benchmarks will maintain their lead. (Kawaumra 2011, pp. 108 109)

This research done in order to identify lean practices, organizational commitment and operational performance in hospitals. This survey was conducted among lean managers and operators of each project in 2009. As per the researcher success of lean directly benefits the internal operations process as well as operational performance