As a Lean Healthcare practitioner, I partner with healthcare facilities to focus the entire organization on the elimination of waste in the systems and processes. We do this by focusing on what adds value for patients. It sounds simple. Focus on adding value for the patient. However, achieving simplicity through so much complexity that has been practically hardwired into the delivery of care models is very difficult. Daily I am reminded of what Apple founder Steve Jobs said: “Simple is hard to do.” He was right.
I often see cutting edge technology while working as a lean healthcare practitioner. The innovation is truly second to none and has added to our overall lifespan and quality of life. However, the facilities that house this innovation are often not designed with the true understanding of supporting processes. It often appears that the building was designed in advance of the processes. The processes are a direct result of the building and not the other way around. In these cases, the patient is often forced to go through extra steps in the process, additional travel, additional motion, and increased waiting due to the total throughput time.
The CFO of a healthcare facility really wants to see the equipment utilized. The return on assets is best met when the lab equipment is doing tests and the diagnostic machinery is occupied. However, while doing Lean Healthcare observations in the “Gemba” (the place where work is done) I often see entire suites of equipment that are “lights out.” It is also common to see several ORs that sit for days at a time or are poorly utilized. In some of these cases, the organization feels they need more capacity and they are actually looking to build more.
Lean healthcare is about having what is needed, when it is needed, where it is needed, and at the time it is needed—all to support the value to the patient. Anything more is waste. Across the country, the variances in the space that is used for the same process volume is massive. In some cases, the space designed and used for identical processes is nearly three times more in one facility versus another.
We have a lot of work to do to in order to be able to deliver maximum value to our patients through Lean Healthcare, and based on the above observations, we have a long way to go to fully implement the system. The “management salad” approach of tossing together a kaizen event, a cup of shredded A3, a drizzle of OD, some sun-dried leadership Kum-ba-ya, and a crumbly topping of half-baked strategy deployment turns into nothing more than a mushy bunch of ineffective tools if there isn’t a deliberate system and intent driving all that activity. Piling on more tools is a path to lots of activity only. The success of those activities will vary and will likely be unsustainable over a length of time.
Many are moving swiftly in the direction of Lean Healthcare. However, as a whole the industry needs a change in thinking and acting. As a whole, we think we are focused on the value add for the patient, but saying it and making it true are worlds apart. With what I’ve been exposed to, I have concluded that it is far too difficult to sneak in a little bit of value for the patient. It has been shown time and time again that most of a caregiver’s time, however valiant their efforts, are heavily dampened by waste within the care delivery system.
Simple is hard to do. Simply delivering value-added care, simply having just what you need to do the work, simply using the resources that you have in an effective manner. What complex and time-consuming paths have you had to follow in order to achieve simple?