I give a lot of lean overview presentations to healthcare audiences. While I talk mostly about the application of lean concepts to healthcare (problem solving, improving flow, leveling workloads, reducing waste… pretty universal concepts), I do acknowledge that lean comes from the manufacturing world.
It doesn't happen often, but sometimes a person raises an objection:
“We don't want assembly line medicine.”
When I hear that, I think, “Wow, manufacturing has a real image problem.”
The connotations behind that objective are:
- We don't want to ignore quality
- We don't want to ignore safety
- We don't want to focus on efficiency at the expense of everything else
Well, of course lean DOES focus on safety and quality. Lean does NOT focus on efficiency on top of everything else.
When people make that comment, I think they're really saying “We don't want non-lean assembly line medicine.” When people think of “assembly line”, they must be thinking of the famous I Love Lucy episode with the candy factory line.
They must be thinking of Charlie Chaplin's movie Modern Times.
People think of dehumanizing, awful examples. When done right, assembly lines aren't bad or dehumanizing. Healthcare could really use a lot of “assembly line” thinking — or “lean assembly line practices”:
- Align all of the value adding steps so they are physically close and in line with each other
- Align the value adding steps so they flow
- Align the value adding steps so there aren't delays
- Make sure the value added steps are done right the first time
- Make sure that the process is improved continuously, with input from all employees
When you think of “assembly lines” in that way, what's wrong with “assembly line medicine.” Medicine, by its nature, will always be more like Dell (each item built is pretty unique) as opposed to a line where thousands of identical products are cranked out.
When you google “assembly line medicine,” about half of the references on the first page are positive and about half are negative. Well, maybe more than half negative. Interesting, huh?