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Lean Concepts Applied in Hospitals
Transcript of Lean Concepts Applied in Hospitals
Waste can be defined as any process that does not add Value.
A Value Added step (process) is:
1. Something the Customer would pay for.
2. The Activity/step changes the form, fit or function of a product or service.
3. It does not create rework and is done right the first time. What is lean Thinking? Lean methodology as with any improvement philosophy has its pros and cons. 1. Improved quality and fewer defects.
2. Reduced Inventory.
3. Requires less space.
4. Enhances overall manufacturing capability
5. Makes identifying future improvements, "kaizens", simpler.
6. Ensures safer work environment.
7. Improves employee morale. Pros Processes that take place on the "front end" of a business are very hard to standardize and "value" is sometimes ambiguous.
Extremely complex processes, such as surgeries, have many variables and often many different outcomes. Therefore, it is hard to anticipate the "Value" that is added.
Altering processes can be particularly difficult for those who have been doing the same thing for a number of years.
Often lean thinking requires discipline in areas that have never been discussed in the past. Cons An example of this is waiting time for patients:
Employee efforts at Meadows Regional dropped ER waiting times from 247 minutes to 139 minutes. Improvement process manager, Brian Leonard, reduced average room turnover time from 30 minutes to 15 minutes through organizing supplies, staff, physicians, and patient in the right place and right time. Root Cause Analysis Keeping inventory low or “just in time” inventory strategy: Use of technology: reduces manual labor and improves efficiency. Pros within the Health industry Eliminating any activity that
is not necessary in
providing patient care. Goshen Health System saved $1.3 million in supply cost over the course of a year through using just in time inventory strategy. Supplies are replenished daily based on demand through use of scanners and bar codes to track supply use. Supplies are placed in areas of the ER where they are more likely to be used rather than in a central storage room. Goshen Health System uses digital control to track and reduce inventory, which reduces labor required. Electronic medical records reduced ER wait times at Meadows Regional by replacing its paper medical record system. Identify root cause of problems and adjusting processes to preventing the problems from occurring again in the future. A lean hospital department would identify process breakdown and improve it. For example, a lean hospital would reorganize supplies for easy access and retrieval. Challenges in Applying
Lean practices in Hospitals •The health care industry is not a standardized practice. Each patient requires individual care and treatment plans. •"Human health is much more variable and complex than making a car, so even if you do everything right, you can still have a bad outcome" George Labovits, management professor at Boston University • The process requires a large culture change at hospitals that have been operating with certain procedures for many years. "If the leadership tries to force new ways of doing things, the staff may chafe under the successive changes" Mark Graban, senior fellow at the Lean Enterprise Institute. •The implementation of these practices takes large amounts of time and training with few benefits seen in a short run. The lean processes are always on going and require constant attention to areas that need improvement •These changes are reliant upon a team based approach and requires large amounts of collaboration. If the entire staff is not on board then time and effort will be wasted In Conclusion The benefits of Lean thinking far outweigh the costs.
As the article illustrates Seattle Children's Hospital:
1. Avoided $180 million in the last six years by improving the firms practices.
2. Was able to Serve 38,000 Patients - Up from 27,000 in 2004.
3. Spent $20,000 refining sterilization. In comparison, the company was considering a $3.5 million to expand the department.
4. Cut the average time a child spends in the hospital from 20 days to 10; allowing the hospital to serve 650 kids per year instead of 400.
5. After refining processes, many surgeries that had to be scheduled out 3 month prior; now only need 1 month notice. "Factory Efficiency comes to the Hospital"
Written By: Julie Weed of the New York Times The article is about Seattle Children's Hospital implementing a program called Continuous Performance Improvement or CPI. It highlights the benefits as well as the challenges from applying a "Lean Thinking" philosophy in hospitals. Mike Hale