By October 6, 2008 0 Comments Read More →

Lean (Not Mean!) in a Thai Hospital

Hospital management to become lean and mean

Here’s an article from a Thailand newspaper, where the “Lean and Mean” bug has also bit editors there (and I won’t repeat my ranting about that, though you can click here for some examples of previous rants or click the Lean and Mean link at the bottom of this post).

Lean, done right, is not “mean” to anyone – patients or staff members.

For example, is this Lean improvement at a Thai hospital in the least bit “mean?”

Very soon, patients will not have to spend hours queuing up to see their doctor or waste their time waiting to be discharged – all thanks to the “Lean Manufacturing” principles.

As the article points out:

Lean management is based on not wasting resources on anything other than serving customers. This management philosophy was initially used by the Toyota Production System, which cut down on the seven time and resource wasting sins – defects, overproduction, conveyance, waiting, inventory, motion and overprocessing – a decision that helped Toyota grow from a small company into one of the world’s largest automakers.

Now, this process is being brought to the health industry.

I’m not sure what to make of this next paragraph, maybe it’s a translation or editing problem:

Under the programme, hospital staff will be trained by Dr Kelvin Loh, a healthcare management expert from Singapore, who will evaluate the services offered, identify the processes that need to be eliminated and design a system that is both flexible and effective.

It’s interesting that the expert is a doctor (I presume a medical doctor). Training the staff is great. But is it the expert “who will evaluate… identify” the problems and improvements, or the staff members themselves? I think the correct Lean model is for the coach/trainer/sensei to train people to see waste and then let THEM figure it out. That’s the model I use when I work with hospitals. If some expert gives people the answers, have the staff members really learned to think through Lean themselves? Maybe not. So I hope Dr. Loh isn’t “making them Lean” or doing it all for them.

“…Thailand’s healthcare industry faced problems in levels of productivity, the quality of services, and often the safety of patients was compromised. Besides, most hospitals, especially public hospitals, have limited manpower and have to cope with increasing workload.

Under the current process, nurses spend little time tending to patients and instead waste most of their working hours ploughing through paperwork.

Wow, that all sounds very familiar, whether it’s the U.S., Thailand, the U.K., or New Zealand. Hospitals everywhere tend to have the systems (or lack thereof) that create the same results and waste.


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Mark Graban's passion is creating a better, safer, more cost effective healthcare system for patients and better workplaces for all. Mark is a consultant, author, and speaker in the "Lean healthcare" methodology. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. His most recent project is an eBook titled Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also the VP of Improvement & Innovation Services for the technology company KaiNexus.

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