Thanks to the Gemba blog. The article he linked to talks about the need to cut costs in healthcare and mentions the Virginia Mason Hospital with its Virginia Mason Production System (as I wrote about this week).
Cost is just one metric. It gets a lot of focus because, well, that's how the business world, media, and society tend to look at things I guess. Lean healthcare is about 1) patients and 2) employees. For patients, safety, quality, time, and cost are important — wait, that sounds just like the classic manufacturing SQDC metrics. Safety and quality go together – which is good for patients AND it decreases cost.
As long as “reducing cost” doesn't mean cutting heads, slashing budgets, or the other things that manufacturing companies typically do, it's OK to want cost reduction. You just don't focus on cost reduction. If you focus on safety, quality, time — AND employee satisfaction, then cost drops.
Focusing on cost is putting the cart before the horse. This is true in manufacturing, healthcare, or any business.
Jon Miller wrote, on his blog, that the real goal of healthcare is prevention. That's a whole other level of complexity, sort of like Toyota's goal of a pollution free car (yes, that is a stated goal of theirs). In the short-term, build the “polluting” cars as efficiently as you can, while also focusing on research in the long-term. In the short-term, we need to use lean and TPS to fix the processes we currently have (“disease care”), while also looking for ways of reducing waste, such as through better preventive medicine.
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