Why lean works
In recent years, extensive international and local work has made it clear that ‘lean healthcare’ can deliver huge gains across every part of the healthcare system.
Every modern health system is addressing 6 great pressures:
- More demand
- Rising expectations
- Budget constraints
- Legal risk
- Declining traditional workforce
- Technical advances
An ageing population with its higher incidence and duration of healthcare engagement putting greater demands on an already stretched health system.
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.
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.
The community expectation of higher and error free standards of quality and safety within our health system for both patients and staff.
An ageing workforce and pay rates diminishing the pool of staff from which to recruit, along with the challenge of building internal leadership capabilities
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.
- For government it is the right approach.
- For clinical leadership it is the right approach.
- For healthcare management it is the right approach.
- For healthcare workers 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.
Health professionals all share a commitment to caring for the patient above all else and so does Lean thinking.
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.
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.