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From the "Far East" to Scotland’s Hospitals

Scotsman.com News – Health – NHS Lothian looks to Far East for ideas

Here's another good example of Lean progress in the UK. In Scotland, they are now focusing on suggestions from front-line employees:

“FRONTLINE health workers are to help design fresh plans to speed up patient treatment and cut down on administrative waste.

Scores of staff will be asked to submit their ideas on improving the way NHS Lothian is run under a new phase of the health board's successful “lean management” scheme.”

They are placing a great deal of focus on patient flow — preventing waiting times for care and improving patient discharge processes.

“The hospital discharge process will be analysed, in a bid to improve the speed at which GPs learn about their patient's treatment and future needs. This can currently take a few days to filter through.”

As with many Lean implementations, this isn't a case of physicians or employees doing work quicker — it's about preventing delays and the waste of waiting.

Here's a nice quote about how Lean has been good for all of the stakeholders:

“Hospital workers today said they have been impressed with the benefits of the lean management approach.

Dr Paul Allan, clinical director in NHS Lothian's imaging department, said: “Staff satisfaction, patient equity and productivity have all increased, and the project has raised the confidence of the service in its ability to change for the better.”

For Lean to be successful, we have to keep everything in balance: patients, employees, and hospital. We can't make improvements for the patients at the expense of the employees (by pressuring them to work faster, for example) or Lean won't be sustainable.

Final quote, looking at results:

A better management of the system allowed appointments to be evenly spread out across Lothian hospitals. At the same time, patients waiting for a routine colonoscopy – used to diagnose colon cancer or inflammatory bowel disease – saw delays fall from 29 weeks to 18 weeks.

That's nice that delays have fallen almost 50%, but I hope they won't stop there. The UK has set goals of waiting 18 weeks, max, but shorter waits would further benefit patients. I hope the notion of “continuous improvement in the pursuit of perfection” holds true. Patients might not be thrilled with that 18 week goal — we have to make sure customer expectations are truly in line with management goals. We can't just stop when we hit the management target.

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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 book 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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