Applying the concept of lean to health care
Applying the principles of lean to health care brings to light what adds value from the patient’s perspective and what does not. Value is defined by the patient. Any task or activity that is not a value-added step from the perspective of the patient is deemed wasteful, and eliminated. This immediately improves flow in the health care setting, relieves staff of the unnecessary burden of wasteful work and helps to optimize the patient’s experience.
To the benefit of the organization’s staff, lean management also reduces workload. In fact, lean tools enable staff to produce the highest quality output with the least amount of work possible! A lean health care organization can quickly realize improved levels of job satisfaction from their staff who are no longer putting in additional hours at the end of the day to do work caused by inefficient processes.
Cutting waste from the health care delivery is not just a good idea, it is an urgent imperative. Employing lean management in the health care delivery model makes this possible.
“Lean leaders demonstrate respect by stepping away from the role of problem-solver, and instead take on the role of problem-framer.”
– Erica Cumbee
Lean health care is…
Promoting a culture of continuous improvement. A lean management system is cornerstone to a culture that puts the patient first. Every day the lean work at Virginia Mason is advancing the quality of health care, as demonstrated by our recognition for patient safety, as we collaborate to achieve zero defects. By measuring the results of our own process improvement, our leaders, providers, and staff continue to be an integral part in our organization’s incremental gains in quality of care, patient experience, staff satisfaction, and revenue generation.
Implementing processes that are value-added from the perspective of the patient, and eliminating those that are not. This means walking in the patient’s shoes, seeing each step with your own eyes and gaining an understanding of what is being asked of the patient each time they come in to see a health care provider – whether it is waiting, traveling across the facility to find ancillary services, or other non-value added tasks.
Aligning leaders and staff around a shared vision. When adopted by an entire organization, the lean management system equips leaders with the tools and methods they need to lead diverse teams of employees. In a lean health care organization, all employees are empowered to speak-up about problems affecting patient care and create patient-centered processes.
Empowering frontline staff to drive improvement efforts, respecting their expertise as the individuals who do the work. Lean leaders demonstrate respect by stepping away from the role of problem-solver, and instead take on the role of problem-framer. In this new role, the leader frames the problem and facilitates the opportunity for the team to implement countermeasures developed by frontline staff. At Virginia Mason Institute, we share the vision of honorary Toyota chairman Fujio Cho, who said, “Go see, ask why, show respect.” When leaders go to the place where the frontline staff deliver care to patients every day, and empower them to drive improvements, staff satisfaction benefits along with the quality of health care.
The willingness to change by identifying the root cause of problems and making corrections to improve processes. Lean management provides the tools and methods to measure improvement and progress over time. Often, a team may decide to implement a solution only to find that it is not working as intended. This is perfectly natural, and in fact, it is the willingness to try new solutions that is more important than the initial results themselves. The lean tools provide everything a team needs to assess whether an approach is producing the desired results as well as the tools to change course and identify a new approach to test.
Lean can be powerful when implemented as a management method in a health care organization. Through a lean framework leaders can promote better stewardship of resources and provide improved care, faster, and more affordably, to patients. Lean training offers the fundamental ideas and tools that are key to propelling an organization forward on their journey to excellence.
Erica Cumbee, MPA, is a transformation sensei at Virginia Mason Institute. Erica trains clients from all over the world to effectively practice lean tools and methods, develops operational leadership emphasizing the importance of acting and thinking in a lean framework and embeds lean management methodology into health care cultures. Prior to joining Virginia Mason Institute, Erica led operations at Virginia Mason Medical Center in Patient Financial and Support Services. She also has served as a Lean Specialist for the organization, where she developed strategic planning in alignment with executive leadership goals, performed evaluation and problem identification in value stream management, lead organizational rapid process improvement workshops, innovation and kaizen events, developed and taught lean curriculum, and coached leaders and staff through lean training and certification. Erica is certified in the Virginia Mason Production System®, experience-based design (EBD), training within industry (TWI) and focus group leadership.
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