Lean Healthcare Exchange

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In today’s competitive healthcare market hospitals must improve.  Healthcare executives and managers should constantly be searching for better and faster ways to deliver efficient patient care.  Lean Healthcare principles challenge us to continually remove waste and improve our processes—it also challenges us to focus on improving the patient experience.

So how do you track patient experience?  How fast can you respond to negative (or positive) patient incidents?  While there are numerous ways to collect and analyze this data, one of the simplest is to listen to your patients.  Do you know what they are saying about your hospital to their friends, acquaintances, and even strangers?

Remember the days when we used to have time to solve problems and let solutions develop?   Well, those days are long gone. We live in a world that moves quickly.  Not only do we have access to virtually all the public information we want, we have it whenever and wherever we need it.  Social networks like Twitter and Facebook allow the world to read other patients’ experiences and share information in real time.

The game has changed.  Healthcare organizations cannot afford to take a “wait-and-see” approach. The culture of social media is here to stay and the sooner your organization includes a strategy to use social media data to improve, the less distance you will have to make up later.

Here’s a potential situation to consider: a patient tweets about a terrible experience in a hospital emergency department. In a matter of seconds hundreds of potential patients are alerted to this patient’s dissatisfaction. The message gets retweeted, and suddenly thousands of people know of the bad experience.

Why not leverage social media to enhance operational efficiency and patient satisfaction?  You can capture social media in real time, alert the proper process owner to mitigate the process breakdown, and create a near instant dialogue to solve a problem.  This can be an operational game changer.

Change your Buzz

Process Improvement and Lean Healthcare methods will provide the framework within which to define the most appropriate use of social media data. Teams can learn how social media tools can be used to improve patient care by collecting and monitoring information your organization has available through HIPAA-approved blogs and social media posts.  Here are a few strategies to get you started:

• Acquire Data: Appoint a manager of social media information. Define what data is available and how easy is it to access or acquire from your organization’s social media channels.
• Identify Trends: Look for trends that are satisfiers and dissatisfiers, identify what process or parts of the organization get highlighted the most.
• Transfer Knowledge: Define who in the organization would benefit from the information.  Develop a process to transfer knowledge and learning.  Use the information for continuous improvement and best practice development.
• Support Collaboration: Encourage teams to support a dialogue of thinking, collaborate with process owners, management and physicians.  Create dialogue for thinking together, capturing group ideas, and putting them in to action.
• Integrate Lessons Learned: Tell the stories, and learn from the positives and breakdowns. Make the lessons actionable.
• Use the Knowledge to Educate: Learn from the voice of customer and educate the organization.
• Repair Process Breakdowns: Use the information to remove waste, redesign or realign processes.
• Be Cautious: While almost all industries are communicating with their customers via social media, the healthcare industry must factor in an added layer of patient privacy.  Make sure your social media standard work (i.e., responses to patient posts and comments) are HIPAA compliant.

The only thing we know for sure is that healthcare is changing.  The culture in which we live impacts our life and job.  Whether you like it or not, there is no doubt that social media has changed the way we think and share.  So, what do we do?  We start with one step forward. Just make sure it’s 140 characters or less.

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In 22 years of helping healthcare organizations with major business transformation and clinical improvement initiatives, I have learned that in most instances organizations rely on the front-line managers to implement and sustain changes.  Ultimately, it is this group that holds the line on cost, productivity, service and quality levels.  I also know from experience that, more often than not, there is a need for fundamental improvement in front-line management skills and tools to support desired change.

Even the most elaborately designed strategies and effectively redesigned processes cannot be implemented and sustained when those responsible have inadequate skills to support the change.  The delivery of Lean Healthcare depends on people, process, and technology coming together.  No matter how sophisticated the processes and technological investments, quality healthcare will always require people effectively managing other people.

Many front-line managers and supervisors are successful nurses, clinicians, or technicians who have not had the benefit of experiencing effective management.  This leads to a results-oriented management approach.  In this type of system, many front-line managers I encounter tend to focus on tasks and position themselves in a “fire-fighting” mode.  They are typically less effective in the discipline of planning, forecasting, coordinating, leading and following-up on expectations.  Often they lack important tools and information with which to manage effectively.  Although difficult to quantify, there is a tremendous cost associated with the gap between current management practices at the front-line and ideal Lean management practices.  These costs are evident not only in lost productivity and decreased quality, but may be expressed also in terms of low employee morale, patient dissatisfaction and lost business. Lean Healthcare organizations that are able to close this gap by enhancing the information and management tools utilized by their front-line managers will have a long-term competitive advantage in the marketplace.

Cognizant of client needs in the coming years of healthcare reform, we can map and analyze processes, collect data, generate practical improvement ideas tied to root causes, design and implement the perfect process with great rigor, and yet still fail to move target metrics and enhance process outcomes. What gets left out of most analytical approaches is a systematic method to manage.  Ignoring management controls and skills means implementing perfectly logical improvement that people cannot or will not use.  It happens all the time. 

Getting Over The Hurdle

A good manager is one who knows how to manage both people and processes effectively.  Organizations today are realizing that in the face of better technology development each day, nothing can substitute the human touch.  A lot of thinking goes into designing more efficient processes which can help minimise waste and low productivity.  Different tools like Kaizen, Lean principles, Six Sigma and Process Improvement have been used with outstanding results in many Lean Healthcare organizations. However, all these tools clearly outline the need to involve each and every employee up and down the ladder for a transformation to become successful.  Empowering managers with the authority to make decisions, effect changes and giving them an understanding of various tools is the key to improvement.

I have found that implementing improvement at the mid- and front-line management level requires real-time floor coaching.  The issue of crafting front-line and mid-level management discipline has typically fallen to training and development programs.  Such programs, however, do not usually impact behavior directly or translate into bottom-line results.  The daily pressure of continually “fire-fighting” at the front-lines gets in the way of managers applying their insights and making real, measurable progress.  Therefore, in order to address the opportunities it is not sufficient to simply train managers in certain disciplines or skill sets.  Focused management development should take the development process out of the “classroom” and onto the “work floor.”  In this respect a mentoring relationship is created, where learning managers learn within their department and give the organization the best chance for real sustainable change.

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