Observation is a powerful tool in Lean Healthcare. Lean emphasizes the elimination of waste to promote continuous flow. To eliminate waste, you must first learn to see it. That often means observing the people doing the value-creating work firsthand at the Gemba and documenting the work exactly as it is being performed.
So why is observation so critical to Lean, especially if you are in a data-rich environment? Observation brings a deeper understanding of the current state and is an important way to identify opportunities for the elimination of waste. It brings to the surface what is truly happening versus what we often think should be happening. In other words, observation does the following:
- Allows you to see the reality of current processes
- Helps identify and quantify waste in the way work is done
- Enables you to better understand the root causes to problems
- Stimulates the generation of ideas that will eliminate root causes
- Exposes hidden costs
For a data-rich environment, keep in mind that data is not a replacement for observation. Data gives you results and shows you where to focus improvement efforts, but observation shows you the waste and the details of the actual process being followed every day.
What will you look for when observing? Along with understanding the sequential steps for completing work processes, there are many flows to be aware of during observation such as patient flow, family flow, provider flow, as well as the flows of medicines, supplies, equipment and information. Typical sources of waste that you will see during observation include:
- Complex communication processes
- Variation in how tasks are completed
- Lack of processes on how to do things
- Poor equipment availability and reliability
- Long travel distances for frequently used items
Challenge your teams to include observation before developing future state improvement plans. From the words of Toyota that are now seen as a basic tenet of Lean, “Go see, ask why, show respect.”
What will you see while grasping the current situation through observation?
Today’s blog was written by Janet Dozier, director with HPP.
Janet has more than 20 years of Lean and process improvement experience in healthcare and manufacturing. She has led lean transformation efforts in clinical, non-clinical, and business operations of hospitals. Prior to her work in the healthcare industry, Janet was in the automotive industry where she was a lead instructor of Lean principles for the Ford Production System.
Janet received her Master’s Degree in Engineering from Case Western Reserve University and undergraduate degree in Industrial Engineering from North Carolina State University.