Lean Healthcare Exchange

Ever been on a flight next to someone?  Normal conversation covers topics of family, weather, work, etc.  Upon mentioning that I work implementing Lean Healthcare principles, I regularly field questions like, “What is going to happen under the new President’s administration?”   To not discuss the pending Healthcare Reform plans would be like ignoring the elephant in the room.  So while I don’t want to open a long debate about politics, I wanted to share some thoughts about the details coming out this week.

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Below is a commentary that speaks to the power of Lean Healthcare, Kaizen, and having a strong facilitator to drive rapid process improvement and deliver results. I hope it resonates with you.

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Whether you are facilitating a Kaizen Event or completing a problem solving A3 in your department, a deep understanding of the Current State is a requirement of any well planned Lean Healthcare activity.  In the effort to define the existing process, we find, almost without fail, that there are as many different versions of the Current State as there are people involved in the activity!  I have witnessed many different reactions to this realization over the years including shock, complacency and pride in the independence of staff performing the work in their own unique fashion.  Through these different reactions, a second prediction can be made just as easily: no one will stop to ask “Why?”

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This question was recently posed to me and I could not help but jump at the chance to formulate a response.  From my personal experience, there are several aspects of the shortage of nursing that lean healthcare can address: (more…)

I’m sure that most of you have recognized that management in a healthcare organization ‘driven’ by LEAN principles should be a bit different from the traditional management paradigm! Although we have covered this topic before, I believe that it is good for all of our readers to reconsider this topic on an on-going basis. One thing is for certain, no matter how integrated LEAN principles and practices are into your healthcare operations, leadership matters!

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Imagine for a moment that you have never flown in an airplane. Today, you will be taking your first flight and confess to being a little nervous and unsure of what to expect.

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One of the Lean principles I constantly work on personally and professionally is “building a culture of stopping to fix problems”.  As a staff nurse and later in nursing management positions, I gained expertise in fixing process problems on a one time basis and often using “work- around solutions”.    Why?  The patient had a need and I, like most caregivers, was committed to meeting their need, right now; thus the problem solving had only two steps Problem >Solution.  Unfortunately, the root cause of the problem was not fixed and I and my peers were likely to face the process problem again and again.  Lean healthcare organizations encourage staff at all levels to solve problems with the scientific method.

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 By now you might have a couple of Kaizen or 5S events under your belt as part of your lean healthcare journey.   Some teams might have established sustainable measures in their areas and Leadership is conducting gemba walks regularly.  The 30-60-90 day follow-up and the lean momentum are progressing and visible.  There is clear evidence that the objectives set by the team(s) are being met and the metrics are headed on the right track.  Small teams are solving problems using A3 thinking.  So what’s next? Continue with the lean improvements? Absolutely.  Spread the lean healthcare methodology throughout the organization, most definitely. Lean is a never ending journey and your focus should always be the goal of zero waste.   In all this good news there should be more good news. Could there be more? Yes, celebrate!  Celebrating wins and successes are just as important as achieving a target.  It’s a common step that I often see organizations leave out of the events and the entire transformation.  I don’t believe it’s done intentionally, but rather that so much focus and energy is directed on meeting the objectives or that there is little belief that lean will work or that lean can really work in a well established organization.

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Building accountability is a common topic among leaders within clinical environments.  When implementing lean healthcare, this tends to come up when a desired process change fails to “stick”, old behaviors return and the process slumps back into its former sub-optimal state.  Sometimes you hear it stated explicitly as the diagnosis for the failure; “There was no accountability”.  Webster defines accountability as “…an obligation or willingness to accept responsibility for one’s actions”.   Based on Webster’s definition let’s examine further.

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As I was dressing my eight month old the other day, I could not help but laugh.  Why are there front pants pockets (albeit on a very small scale) in my daughter’s size 12-month blue jeans?  Anything that could even fit in the pocket would easily qualify as a choking hazard.  My initial reaction was, “that is the way jeans are supposed to look.”  However, I suddenly stopped.  I had just repeated one of the phrases which, as a change agent, we are conditioned to detest. 

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