I was fortunate to have the chance to speak and visit at a few hospitals in Sweden back in February, 2010 (see my blog post from that year). One of those hospitals, St. GÃ¶ran (in Stockholm), was recently featured in the magazine The Economist for its use of the Lean methodology:
The hospital was, at the time, the one public hospital that had been set up to be managed by a private European company, Capio.
From the article:
Doctors talk enthusiastically about “the Toyota model of production” and “harnessing innovation” to cut costs.
Welcome to health care in post-ideological Sweden.
St Goran’s is now a temple to “lean management”â€”an idea that was pioneered by Toyota in the 1950s and has since spread from carmaking to services and from Japan to the rest of the world. Britta Wallgren, the hospital’s chief executive, says she never heard the term “lean” when she was at medical school (she is an anaesthetist by training). Now she hears it all the time.
Some other points from the article:
Lean is described properly as having the dual pillars of “flow” and “quality” (which is straight from Toyota). The Economist thankfully gets that right when the Wall St. Journal has so often gotten it wrong by describing Lean as just the flow component (or “just in time”). Also usually getting it wrong, by the way, are the “Lean Sigma” people who think Lean is just about efficiency while Six Sigma is the only approach for quality (see an example).
But back to Sweden…
The article talks about how doctors and nurses now work in teams, instead of keeping their professional distance from each other.
Staff are now not just doing their work, but they are also suggesting “operational improvements” as well (that’s Kaizen, or continuous improvement).
St. Goran is not a luxury environment. There are four to six patients to a room (which seems to be the norm in Europe, unlike our American private or semi-private rooms). Yet, infections have been decreased and patient flow and throughput have increased.
The aim is to give taxpayers value for money.
There are other hospitals in Sweden, managed as part of the usual public/government sector, that are using Lean methods, including the hospital in Skaraborg, which I also visited.
The hospital in Karolinska is also known for using Lean (as documented in this presentation).
The Economist wants to make it a story of “private vs. public.” The article claims that private hospitals are more able to get their employees to try new ideas (I’m not sure this is true) and that they are more likely to share good ideas across borders (I’m not sure private U.S. hospital systems share good ideas across state lines).
The real battle, in healthcare around the world, is “Lean vs. the old way.”
Earlier blog posts about my trip to Sweden, or referencing the hospitals there:
- Right Sized Capacity in a Stockholm Hospital
- Lean in Sweden: Tools < Thinking
- Improving “Door to Balloon” Times and Patient Care – in Some Hospitals, Why Not Every One?
- Thinking and Adapting in the Context of Standardized Work
About LeanBlog.org: Mark Graban is a consultant, author, and speaker in the “lean healthcare” methodology. Mark is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as the new Executive Guide to Healthcare Kaizen. Mark is also the Chief Improvement Officer for the technology company KaiNexus.