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Whilst healthcare talks about small percentages, many industries count mortality rates in smaller events per million.

A leader amongst those industries is aviation and this seminar brings a leading quality and safety advocate from healthcare with the former head of human error for one of the world’s largest airlines.  Together they present a myriad of ways in which healthcare can make changes, many of them simple, to radically improve quality and safety.

Melbourne Friday, 7 October 2011 AND Perth Tuesday, 11 October 2011

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LHC welcomes the Australian Prime Minister’s statements to this effect.

Perhaps Australia does not only face a choice of;
1. Cutting pensions, health services and aged care;
2. Running massive deficits; or
3. Boosting productivity as the population aged to help lift tax revenues.

The systemic application of lean thinking to the healthcare sector offers a far less painful but incredibly effective contribution to reducing the stress on the healthcare sector, even as demand grows.

Lean thinking orients the clinical and managerial focus toward the value being delivered to the patient and opens the way to freeing existing resources for redeployment and adopting new delivery models that add to safety, quality and productivity.  “Lean tools provide an informed framework that is effective and easy to use” said Lean Healthcare Consultants’ Director Peter Boyce today (1/2/2010) “Extrapolating our team’s experience, 10-15% savings are very deliverable, more if a truly systemic approach is taken” he added.

Health spending pressures are reported to account for up to two-thirds of the total projected increase in government spending over the next 40 years. Refining the carve-up of commonwealth and state responsibilities to fund and run the nation’s public hospitals has only limited ability to change the actual cost (other than resolving administrative overlap). Many industries (automotive and aviation are two) have already been able to achieve 20-50% reductions in resource demand per unit of output and the US and UK health systems are now approaching ‘lean’ in a more systemic way.  Supporting a system wide uptake of lean principles (in the same way as the global automotive industry emulated Toyota in the late 20th century) makes sense for public and private healthcare, for health insurance, for dental and allied health.

(This article has been informed by reporting in The Australian newspaper)

The development of super clinics requires many interlinking participants to be genuinely aligned if the clinics are to become a reality.  A reality both physically and in the range of intergrated service improvements they provide.  The Australian revealed today claims that seven of the planned 35 GP super clinics were operational were greatly over stated. Six were only complete, with at least two offering little more than conventional GP services. One is being fully funded by the Northern Territory government. All this two years on from the current government promise to fund medical one-stop shops in areas struggling with inadequate medical services.

The centres were to offer after-hours general practitioners, specialists, mental health services, chronic disease management, allied health practitioners and training for medical students and trainee specialists but this range is well beyond what even the present centres are contemplating it seems.
This integration of services in a manner which eliminates the time and movement waste of distributed services is laudable.  Indeed, if the strategy includes ensuring that waste is not recreated (the use of lean thinking on a continuing basis) then the super clinics offer a range of tremendous benefits to all participants, making goal alignment easier.

LHC welcomes the appointment of a CEO the calibre of Mark Cormack and the role this organization will play in producing more effective, streamlined and integrated clinical training arrangements and supporting workforce reform initiatives. There is tremendous scope for improving the patient journey, reducing impediments to work flow and eliminating resource waste in engaging clinicians in the entire value streams in which they play such a pivotal role. Link

The COAG decision to release $300M in additional funding to reduce elective surgery waiting lists is a very welcome development. States and Territories are required to exceed individual targets, increasing the total number of surgeries performed to access further payments. Increased surgery throughput often has the effect of straining many other systems within hospitals. Process improvements will be needed to accommodate the growth. Not to make those improvments risks locking up beds and other human resources and extending waiting times in other areas of the healthcare delivery. Link

His flagship heart hospital charges $US2000 ($2187), on average, for open-heart surgery, compared with hospitals in the US that are paid between $US20,000 and $US100,000, depending on the complexity of the surgery.
The approach has transformed health care in India through using a clear value stream (such as heart surgery) as a high volume and specialised flow system to drive down the cost of health care in his nation of one billion. On the outside it looks like simple ‘economies of scale’ but LHC would argue that whilst true, such cost reductions derive from a well understood value stream in which all possible waste is eliminated. (In this case, an example of waste would be the ‘changeover cost’) Doing this, without eliminating that which adds to the quality and safety of patient care is instructive for healthcare systems everywhere. Link

After attending ‘Using LEAN to lead change’ participants walk away with both the knowledge and skills to lead healthcare environments in direct, rapid and continuous advances in  quality, safety and care, improving flow and reducing waste.   Invest a day in yourself and contribute more for years to your organization.

If you want to make a difference to the quality, safety and care delivered by your organization and eliminate waste to free the resources to do it, this workshop is designed for you.

If you are an executive leading people in continuous improvement, this workshop is designed for you.

If you are interested in the latest application of ‘lean thinking’ as an effective strategy for transforming healthcare, this workshop is designed for you.

About Lean Healthcare Consultants

Lean Healthcare consultants have assisted healthcare organizations throughout Australia and New Zealand in developing and applying ‘lean thinking’ to healthcare. Our work extends across emergency departments and wards through to primary and community care. Our experience includes specialist streams such as oncology, diabetes, chest pain, respiratory, complex medical patients, theatres, orthopedics, pathology, radiology, pharmacy, outpatients, oral health and aged care. We also have extensive experience working across streams such as with, corporate services, acute to subacute, ED to Ward and Discharge to community / GP.

Course leader, Pieter Walker, currently Director of Lean Healthcare Consultants, also works extensively with the Health Roundtable in Australia and New Zealand and has worked internationally. From his origins in psychology and healthcare management, he has been in healthcare executives for 19 years, the last 5 with ‘lean thinking’ for healthcare. All this experience is captured in this formal workshop offered in Melbourne, Sydney and Brisbane. The workshop provides the very latest information from around the world in how lean thinking is being applied to healthcare. This is a workshop you will not want to miss.

Who will benefit?

• Directors of Nursing looking to stimulate improvement and encourage team work
• Executives looking to refresh and update their LEAN skills
• Healthcare organization administrators and managers
• Government department leaders
• Department and service leaders
• Clinicians with change management responsibility
• Newly appointed service or department managers looking for change techniques

How will you benefit?

• Gain confidence in the certainty of improvement provided by ‘lean thinking’ for healthcare
• Learn how to build a whole of organisation approach to LEAN
• Learn how to sustain changes in the long term
• More confidently and strategically map your change program
• Better engage colleagues and staff in the use of ‘lean thinking’ for healthcare
• Understand how to quantify the benefits of ‘lean thinking’ changes
• Implement an effective ‘lean thinking’ strategy
• Demystify preconceptions of what ‘lean thinking’ can and cannot do

Event details

Lean Healthcare Consultants ‘lean healthcare programs’ focus on:
• Improving the patient experience
• Delivering excellence – improving quality & safety
• Improving work flow and working life in healthcare and
• Eliminating waste

The inevitable consequence of our programs is that many, many costs are simply eliminated, freeing resources (cash, time, space and equipment) for improving quality, safety, care and flow including caring for more patients, sooner.

RESPECTING YOUR PEOPLE

Our programs are designed around an adult learning environment where action learning and emotional intelligence play important roles. The programs are filled with examples, anecdotes and healthcare only diagrams and case studies. Projects being worked on reflect the priorities and needs of the people in the project team and the healthcare facility or department leadership.

CONTINUOUS IMPROVEMENT

Improvements are achieved from the commencement of our programs and grow over time. Improvements occur quickly at first as the so called ‘low hanging fruit’ is easily accessed. Progressively, as confidence with ‘lean healthcare tools’ grows and the experience of change is positive, larger and more systemic, cross functional projects are tackled – with confidence and skill. A consistent, long term application of healthcare specialised ‘lean thinking’ to your organization can deliver leadership results similar to those achieved by Toyota in vehicle manufacturing and many, many healthcare facilities around the world. That is:

“more effective, efficient, high quality, safer, durable, caring and inexpensive healthcare accessible to a growing proportion of the population”

HOW TO BEGIN

Our programs are built on the identification of valuable projects, the right project team members, training and coaching to complete projects and value creation appropriate to budget demands. As programs progress, you’ll become more competent with frameworks like 5S, the 8 wastes, spaghetti diagrams, queue reduction , value stream mapping, pull systems, one piece flow, standard work, visual workplace, leveling, quick changeover and error proofing; to name a few.

Any lean healthcare journey begins with a discussion. Click here to see our team and call one of our Directors for a no obligation discussion.

OUR PEOPLE

We are a team of qualified and experienced specialists. We focus solely on healthcare. We advise, customize, train and coach, improving quality, safety, flow and reducing waste in healthcare services.

Leveraging more than 19 years of healthcare experience we have tools specific to the needs of the healthcare sector. We help you improve the quality and safety of patient outcomes. We help healthcare leaders balance demand and flow within resource limitations.

Patients, government and healthcare professionals have a rising expectation of patient outcomes, waiting lists and quality of care. Performance targets continue to be set higher. Patient numbers are accelerating faster than resources. This tension demands a proven and trusted approach suited to the healthcare environment.

Our specialist healthcare methodology, utilizing lean principles, is designed to assist you to balance these competing pressures in a strategic, systematic and people supportive way. We are both proven and trusted in healthcare.

	Pieter Walker 18 years healthcare, 5 in lean & leadership BSc (Hons) Psych		Jamie Wilson 5 yrs management consulting, 4 yrs hospital management MSc (Health Policy & Management)
	Tamara Obadage 5 years HR and operations BBus (HR)		Are you interested in a career in advising, training and coaching ‘lean thinking’ with the healthcare industry? Let us know.

We advise, customize, train and coach.

Hospitals: Clinical flows, ED, Theatre, Wards, Outpatients and Treatment streams	Health Executives and Future Leaders	Diagnostic Services: Pharmacy, Radiology, Pathology	Discipline Specific Services: Nursing Medical Allied Health	Primary, Community & Aged Care	Non-clinical services: Corporate, Food, Logistics, HR, Travel, Administration

Lean Healthcare Consultants will:

1. Advise you on the basis of our expert knowledge of Lean thinking, of healthcare and of the successful application of lean thinking to healthcare, to help you transform your organization.
2. Customise program design to the current experience, expectations and situation of your organization today.
3. Train you and your organization via customized adaptations of proven programs, so your experience of us as well as of Lean thinking for healthcare is high quality, flows easily and avoids waste.
4. Coach you and your people to become the leaders and drivers of Lean thinking including, to the extent you wish, as internal trainers to your organization.

Specifically, we offer the following core programs customized to your specific requirements (We are also able to offer custom designed programs for health departments, corporate healthcare environments and multi-site state, national and international healthcare groups). Programs are content rich and efficient learning environments but also fun. We utilize more than 200 healthcare specific case studies. Program design is structured to embed sustained learning and sustained change. See the testimonials to the bottom right of the screen for examples of participant feedback from programs run by our consultants.

Lean Healthcare Consultants’ methodology emphasizes the role of experiential learning in adult professional environments and extensively uses real improvement projects and project teams. At the same time, incorporated into every program is a sense of enjoyment, entertainment and interaction.

Our customized training and coaching delivers immediate gains. We help you build a culture of successful problem solving & continuous improvement and move progressively to the more challenging, collaborative and system wide improvements. We do this offering technical help, training and coaching, suited to an adult learning environment. We simultaneously:

1. Support improving the quality and safety of patient care and

2. Balance program priorities and results delivery within resource limitations

Lean Healthcare Consultants has a particular methodology with ‘lean thinking’ at its core to make this possible.

1. Our programs have grown up in healthcare – not manufacturing – so they are more easily understood and adopted in healthcare environments.

2. Our programs combine learning, teaching, coaching, entertainment, caring and commerce in a carefully crafted balance.

3. Our programs target strategic priorities – we will work with you to shape and customize to achieve optimum value for you.

Every modern health system is addressing 6 great pressures:

1. More demand

An ageing population with its higher incidence and duration of healthcare engagement putting greater demands on an already stretched health system.

2. Rising expectations

Rising community expectations of the range and quality of treatments that should be accessible to all citizens, increasingly ‘on demand’. No waiting lists or waiting hours for treatment.

3. Budget constraints

Rates of growth in GDP and tax revenue that do not keep pace with the rising cost of healthcare delivery in the face of significant national debt and current account deficit pressures.

4. Legal risk

The community expectation of higher and error free standards of quality and safety within our health system for both patients and staff.

5. Declining traditional workforce

An ageing workforce and pay rates diminishing the pool of staff from which to recruit, along with the challenge of building internal leadership capabilities

6. Technical advances

Scientific and technical advances improving and expanding the capacity to treat, even cure, more adverse patient conditions.

Lean Healthcare Consultants offers a ‘whole of system’ strategic change framework that redresses all 6 pressures. ‘Lean thinking’ offers healthcare direct, rapid and continuous advances in redressing all six pressures.

THE ORIGINS OF ‘LEAN THINKING’

‘Lean thinking’ describes the insight James Womak and Daniel Jones popularized describing the global success Toyota achieved through its ‘production system’. The Toyota system is truly remarkable, delivering in its industry, the:

• Fastest product development cycle
• Highest quality & reliability
• Highest productivity
• Greatest flexibility
• Fewest manufacturer recalls
• Most profitability

From: The Toyota Way – Jeffrey Liker, 2004

Put simply, the system made quality, flow and waste elimination the primary means through which customers were delivered the best possible vehicle for the least possible use of resources. Cost cutting was not the aim – rather to improve the output and reduce waste.

Subsequently, a comprehensive range of tools and techniques have been identified and codified. Since the early 1990s, ‘lean thinking’ has slowly and successfully migrated into many countries, organizations and industries. One of the industries adopting and achieving great success with lean thinking is healthcare.

LEAN THINKING IN HEALTHCARE

Lean thinking is an excellent strategic fit for healthcare. Lean thinking demands that the quality and safety of care and the patient journey (flow) must be continuously improved. Simultaneously, lean thinking demands that more and more waste be eliminated. Cost reduction is never the focus. (Lean thinking will inevitably, however, continuously free up more and more resources for reallocation to quality, safety and flow).

This strategic use of Lean thinking is strongly aligned with the culture of healthcare.

1. For government it is the right approach.

Lean thinking is focused on quality of care, the patient journey (flow) and the elimination of waste – precisely what is expected of government.

2. For clinical leadership it is the right approach.

Health professionals all share a commitment to caring for the patient above all else and so does Lean thinking.

3. For healthcare management it is the right approach.

It is important to understand that studies consistently show that close to 80% of all effort and resources expended are waste – but most of this waste is invisible. It is invisible until the tools and techniques of lean thinking are applied, helping staff “see” the wastes. Suddenly, all manner of ways to make things simpler, quicker, safer and without error, become increasingly obvious. Ask us for examples.

Importantly it builds a culture of continuous improvement, where staff come to work everyday to resolve problems to make each day a better day for patients and for themselves. Immediately managers unlock more resources for quality, safety and flow, reducing the stress on staff, patients and budgets.

4. For healthcare workers it is the right approach.

Whether in the office, on a ward, in theatre, in allied health or anywhere else, all of us share the desire to improve the patient outcome. That is exactly what the adoption of lean thinking so obviously and powerfully pursues.

Whether working within government health departments, hospitals, aged care, or primary & community care, ‘lean healthcare’ has proven its value all over the world. Working with emergency departments, pharmacy, radiology, pathology, transport, HR and IT, food services, supply chain or any other part of the system, ‘lean healthcare’ has evidenced significant and consistent achievement. Notable are the big benefits to care delivery in very high cost patient care areas such as chronic complex and aged patients, , diabetes, respiratory and heart disease, theatre and surgical flow, orthopedics, oncology, mental health, corporate services – throughout the system.

The team at Lean Healthcare Consultants has worked with more than 100 healthcare facilities on every one of these types of projects and experienced firsthand, the sustained improvements made by the teams we train and coach.

WHY LEAN WORKS SO WELL IN HEALTHCARE

Most waste is completely invisible. To understand why ‘lean thinking’ for healthcare works so well, you must appreciate that only 5-15% of all the effort made is adding value to the care of the patient or resident. All the rest is what ‘lean thinking’ identifies as waste.

Once you are using lean thinking tools and techniques, you will be able to see more and more opportunities to improve care (quality and safety), improve the patient journey (flow) and eliminate more and more of the waste. Indeed, most often, the changes you will identify do all three – simultaneously.

HOW CAN THERE BE SO MUCH WASTE?

The simple task of ‘searching’ (for a file, tongue depresser, key, patient, wheelchair, drug, staff member…..), is repeated hundreds of millions of times a year – searching is an example of waste and much of it can be eliminated using lean techniques. Bottlenecks create massive spikes in waste – through the rework, treatment delay, increased requirements for space, increased time pressure and errors, equipment and staff use and in many other ways.

Information lags create re-work and mistakes that must be fixed – both are waste. Having to ask the same questions repeatedly is waste. Walking further than necessary is waste. Time spent waiting is waste. Rather than identifying the root cause of the problem so it never occurs again, staff find inventive ways to workaround problems, which inevitably create more waste.

Through the lenses of ‘lean thinking’, it becomes increasingly obvious that 80% or more of resources being expended could indeed be waste – much of it readily eliminated.

‘Lean healthcare’ is not trying to change clinical treatment. ‘Lean healthcare’ is not asking people to work more or work harder.

‘Lean healthcare’ is simply, consistently and reliably, reducing the waste between each value adding activity, freeing more and more time and resource for redeployment to the treatment and wellbeing of more patients and more staff.

‘Lean thinking’ is a powerful, strategic solution to the challenge of delivering more and better healthcare to more and more people.