leanhealthcare_flavorofmonthIf you work in healthcare long enough you will see a lot of programs come and go — and some will even come back around again!  Various methods for enhancing quality and safety have been no exception to falling in and out of favor.  Over the years the “flavor-of-the-month” has gone from Continuous Quality Improvement, to Total Quality Management, to Six Sigma, to Lean.  Participants sit in educational sessions, being indoctrinated with the newest discipline, all the while exchanging knowing glances of “this too shall pass!”

But is the real issue the obsolescence of these disciplines or the inability of leaders to sustain them?  Consider some fundamental principles of Lean:

  • intense focus on the patient as customer
  • minimize waste to maximize value
  • system vs. silo thinking
  • continuous improvement

It’s hard to conceive of even one of these core ideals falling out of favor.  Which could any health facility dismiss as outdated?

To be successful, it must be acknowledged up front that we can not expect to hold the gains of new Lean processes without also investing in a mechanism to ensure their accountability and sustainability.  A key solution is the adoption of a management system.  As Lean processes are launched, a management system must go hand-in-hand.  It is the management system that ensures leaders have the tools they need to drive the development of standard work, the tracking of performance, and the execution of continued improvement. The system provides process structure and accountability that enables the sustainability that has eluded past “flavors of the month”.

Without taking the steps to hardwire a Lean organizational culture, the binder filled with Lean tools will almost certainly join the other “flavors” on office shelves.  With a management system however, we have a way to break the cycle and sustain a set of principles which can stand the test of time.


KendallKarenRSToday’s blog was written by Karen Kendall, RN, consulting director with HPP. Karen is a registered nurse with more than 30 years of healthcare experience in clinical and leadership roles.

Before joining HPP, Karen led multi-disciplinary teams through operational and space planning and work redesign efforts which resulted in in significantly improved efficiency, patient satisfaction and employee engagement. She has extensive experience in campus master planning, equipment planning, and way-finding. She has also served in clinical and leadership roles in a variety of areas including invasive cardiovascular services, surgical services and pediatrics.

Karen holds a Bachelor of Science in Nursing degree as well as a Master of Healthcare Administration degree from Duke University.

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