What is Lean?

NO! Lean is none of those things!

Lean is an ever-evolving philosophy based on proven principles and practices aimed at the elimination of wastes. Lean, the Toyota Production System, waste elimination, and process/continuous improvement are used synonymously with the term Lean. Lean is a compilation of world-class practices that will improve an organization through an evidence-based methodology.

Lean’s purpose is to eliminate all waste or non valued-added activities from a process or system. Lean is not meant to eliminate people, but to use them more wisely. With that thought in mind, job duties (tasks) may need to be modified to accommodate a waste-free (Lean) environment. This will allow healthcare facilities to improve patient safety and care while creating a culture of continuous improvement.

Lean is about working with people to achieve continuous improvement activities to assist in reducing cost in an organization. Manufacturing organizations still make the mistake and use Lean to reduce people. It has given Lean a bad name for some. Since it has been derived from the Toyota Motor Corporation, and they have never laid off an employee, Lean should never be used under those circumstances.

Lean should be part of the overall business improvement system for the organization. It should be included in the strategic plan and conveyed through various goal setting activities. The focus of Lean may be improving the non-patient care processes where most money is spent. In so doing this will improve the direct patient care processes also!

Why?

Because the basic values of Lean Healthcare are to:

• Put the customer (patient) first
• Define value in terms of the customer
• Learn to see the 7 Wastes of Healthcare
• Make “Less is More” the way we do things

To be a Lean Thinker means to constantly strive to improve by focusing on driving out waste in all its forms. By attacking the ever-present 7 Wastes of Healthcare, greater value can be created with less effort.

Lean is a system that allows you to develop, improve, and sustain superb processes. Lean brings the tools that have been used, refined, and proven through over 50 years of use in manufacturing and service industries to the healthcare environment. Understanding Lean in Healthcare maybe a challenge. However, it has proven successful in every industry type (i.e., construction, financial services, armed services, education, manufacturing, etc.).

***Lean is based on reducing costs rather than raising prices (or reducing services).

WHY LEAN IN HEALTHCARE?

• 20,000 incorrect drug prescriptions per year U.S.
• 500 incorrect surgical operations per week
• 50 new born babies dropped at birth per day
• Enormous defect rate (estimated at nearly 45% by the New England Journal of Medicine, June 26, 2003)
• Cost escalation (e.g.,General Motor Corporation reported in 2005 that healthcare expenditures equate to $1,525 per car)
• The $1525 cost is more than the steel to make the car!
• 60%-80% of costs can be reduced
• Work and patient flow will improve
• Patient as well as non-patient care processes will improve
• Improves morale, Productivity and Bottom Line

“For every dollar spent on healthcare over 75% is spent on non-patient care activities of communicating, scheduling, coordinating, supervising, and documenting care.” HealthMEDX, 2005

It’s not only about the numbers

“I’m frustrated with all the extra duties and activities unrelated to my giving direct patient care.”

“I thought I was scheduled for 8:00 a.m. It’s 9:00 a.m., and I haven’t been seen yet.”

“I can’t find anything around here when I need it. I spend over 20 minutes whenever I need a metal speculum to do a colposopy.”

“I spend 45 minutes every time a new patient is admitted waiting for their medical records to be delivered.”

It’s about improving patient care as well as non-patient care activities!

Lean healthcare is the successful adaptation of Toyota way principles to healthcare processes and management. These are universally applicable principles such as the continuous removal of waste and non value added, built-in quality through "stop and fix" mentality and the discipline or root cause problem solving, and ongoing improvement through empowerment and respectful people.

Lean Healthcare cuts out wasted time and resources, increasing the efficiency of the process of admitting and treating patients, thereby allowing more patients to be treated. This allows hospitals to leverage existing assets, generating higher margins. The benefits of Lean healthcare are significant, but go beyond financial rewards.

Lean Healthcare looks at the process of patient care from a cross-functional viewpoint instead of from the viewpoint of individual functional departments. Both outcomes and patient satisfaction depends on a healthcare experience that is a smoothly flowing series of connected steps.

Today healthcare is not designed to make this value stream of care flow smoothly. The solution is the Lean healthcare delivery system and enabling those on the front line to work together to solve problems and take root cause countermeasures. This allows healthcare professionals in all units and departments to better focus on the objective – greater patient satisfaction at a lower cost.

Healthcare facilities must find ways to conserve resources in order to keep costs contained and reduced to ensure patient health and safety. This can only be accomplished by reducing waste through continuous improvement. And that will improve profitability for the hospital.