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What is LEAN Healthcare?
Lean Six Sigma in Health care is the use of “lean” ideas to improve healthcare. Learn how a Lean Healthcare certification can improve patient satisfaction and care outcomes and reduce costs.
Lean healthcare refers to using “lean” ideas within healthcare facilities to reduce waste in all processes, procedures, and tasks through an ongoing improvement program. All employees of an organization, from the clinicians to the operations and administration staff, must use lean principles to continuously identify waste areas and eliminate any that do not provide value to patients.
Healthcare industry members have used the Principles of Lean manufacturing to find solutions to the unsustainable 5.5% per annum projected increase in national health expenditures. This has helped to rein in costs and provide value for patients. The Lean Manufacturing principles focus on improving customer satisfaction (payers and patients) and making it profitable. Lean principles are fundamentally about eliminating waste at all levels of an organization. Because “lean thinking,” which requires buy-in by every member of an executive team, is deeply embedded in the culture and results in innovation at every level. Organizations can also improve patient satisfaction by implementing lean healthcare. Decisions and processes are becoming more patient-focused.
Lean Six Sigma Healthcare
Lean and Six Sigma can sometimes be confused. However, they are often used together in healthcare and other industries to make improvements. But they do it in different ways. Six Sigma, a metrics-driven system, is used to reduce medical errors and eliminate defects in healthcare delivery processes. Both methods aim to optimize operations and improve patient care. While Lean is focused on removing waste, Six Sigma focuses on decreasing defects to a particular statistical measure. The two systems have been combined to create “Lean Six Sigma,” a hybrid improvement process.
Virginia Mason, the creator of the Virginia Mason Production System, is a leader in implementing lean principles in healthcare. They argue that Lean is the best overall approach to healthcare improvement because it values all members and can be applied by anyone. Lean, unlike Six Sigma, does not require expensive training or advanced statistical methods. Lean values can be used incrementally in a continuous journey towards value-based healthcare. Every patient interaction and each care episode are opportunities to cultivate value and reduce waste.
Healthcare Lean Methodology: The “8 Wastes”
Taiichi Ahno, Toyota’s founder of lean principles, identified seven waste areas in every industry. Toyota later recalled the eighth. Although it may seem counterintuitive to apply the same manufacturing principles in hospitals, lean healthcare can be implemented and processes and systems reviewed through the lens of eight wastes.
- Reduce Waiting Time According to lean principles; waste occurs whenever employees or patients are forced to stand still. Healthcare organizations have many opportunities to increase waste reduction. These areas include waiting rooms, latecomers unable to attend meetings, appointment waiting lists, and idle high-tech equipment.
- Inventory is tied-up capital and storage costs. Inventory waste is when there are excess supplies, medications, unnecessary equipment, data that isn’t necessary, and stockpiles of preprinted forms. Additionally, inventory waste increases the chance of inventory being stolen or obsolete. All employees can learn to identify excessive inventory and find new ways to reduce it.
- Reduce Defects in Healthcare to Improve Quality and Increase Reimbursement System failures, medical errors, and misdiagnoses all constitute defect waste in healthcare. Defective healthcare includes conditions like blood clots and infection, medication errors, medical mistakes, misdiagnosis, and avoidable readmissions. Organizations can use lean principles to motivate employees to eliminate defect waste and improve quality. This will help them to reduce costs and avoid making mistakes as payers shift to pay-for-performance models that reward/penalize results.
- Transportation – Reduce the Movement of Patients and Supplies to Improve Patient FlowTransport waste in healthcare refers to unnecessarily moving patients, medical equipment, and supplies. Moving patients around and running to get supplies can increase caregiver or patient injury and cause delays in care. To save time, reduce harm and improve patient flow, Lean Thinking can be used to analyze caregiver and patient movement within the hospital facility.
- Avoid Injuries and Reduce Motion Hospital workers who move in their work area that is not beneficial to patients are considered motion waste. Motion waste can be caused by hospital workers reaching or stooping to get frequently used equipment or increased walking because of poor building design.
- Maximize Resources by Minimizing Healthcare OverproductionOverproduction waste entails redundancies, creating too much of something, or creating it at inappropriate times. Healthcare organizations can address overproduction by preparing medications for discharged patients, extending hospital stays beyond necessary and duplicating tests.
- Remove Waste from Over-ProcessingOver-processing occurs when unnecessary work goes into treating patients. Examples of unnecessary testing include filling out multiple forms with the same information and data entry in more than one system. Lean analysis can help you identify and eliminate wasteful processes that waste time, effort, or resources. Staff can identify redundant, inefficient, or less valuable strategies by applying lean healthcare to all their operations. This will help save time and money.
- Untapped Human Potential in Healthcare Waste – The Pinnacle of Healthcare Waste When healthcare waste takes up too much of a worker’s time, it makes it difficult for them to utilize their creativity and talents to create work that improves patient care optimizes operations. Healthcare waste robs healthcare workers of time that could be used to pursue education, build relationships with patients or implement system-based improvements. Lean culture leads to lower costs and better care and improves employee morale.
Lean Healthcare Tools
Lean Healthcare Examples
Hospitals and other healthcare facilities are using lean healthcare certification principles to improve patient satisfaction, schedule appointments, decrease overtime work, process paperwork, and increase clinic revenues. Here are some exciting examples of poor healthcare:
- Redesigned Patient Rooms At ThedaCare, supplies, medications, and electronic-record-keeping systems were relocated into patient rooms, allowing nurses to spend 70% more time with patients. Patient safety was also improved by installing ceiling lifts in patient rooms and beds equipped with alarms, scales, and other equipment.
- Crash Cart Inspections Nicklaus Children’s Hospital reduced inspection times for crash carts from three hours to ten. This was achieved through visual optimization and the elimination of excess equipment.
- Lean Scheduling – Due to long wait times and transportation issues, Dyad Mother/Newborn Appointments For Postpartum Care Denver Health’s Eastside Clinic saw many no-shows at maternal postpartum checks. The clinic combined the infant and mother’s appointments to address this problem and promote patient-centered healthcare. This resulted in a drop of more than 50% to 15% in no-shows.
- Patient Safety Alert System One of many initiatives at Virginia Mason is the Patient Safety Alert System (PSA). This system allows all staff to report any patient safety concerns. All concerns reported are immediately investigated, and interventions are implemented promptly. This system has resulted in liability claims at Virginia Mason decreasing by 74% between 2005 and 2015.
Lean Principles in Healthcare Certification
More and more healthcare providers have been using lean methods to improve their quality of care and reduce costs since the Global Lean Healthcare Summit in 2007. It has been challenging to apply concepts from manufacturing to healthcare. This required a thoughtful approach to adapting these ideas to the hospital setting.
For their fresh insights, healthcare leaders value the perspective of front-line clinicians. Every employee in the organization must ask, “Does this add value to the patient?”
Organizations can use various tools to implement change when applying lean principles to healthcare. It is crucial to eliminate steps and processes that don’t contribute to patient satisfaction or superior care. Healthcare leaders value the perspective of front-line clinicians as they can offer new insights. Every organization member must ask, “Does it add value to the patient?” Gary Kaplan, CEO of Virginia Mason Health System, says leaders need to think beyond lean to implement change.
What other Lean Healthcare Tools do you know about?
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