A Lean Hospital Example in Houston
Here's a nice case study / profile article in the news about St. Luke's Episcopal Hospital in Houston, Texas.
The first photo caption has a great example of using Lean to improve patient care:
“Studies show us time and again if you walk into the emergency room with chest pains there's a 90-minute window where you get the best outcome … This lean system has helped us hit that target every time now for 10 months.
Dr. David Pate, the CEO of the hospital, touches on some really key points, including the need to improve value streams instead of just suboptimizing departments:
First, it's important to understand the whole system. We map everything that happens to patients. Then we want to identify and eliminate all the bottlenecks and wasteful processes.
We don't want to optimize departments. If I put pressure on the cath lab people to make it the most efficient and profitable it can be, their cost-cutting will cause problems in another unit. We won't have the staffing we need to give people great care no matter what time of day they come in.
So optimizing a department is useless. What we need is the ER and the cath lab working together as fast and best as they can. (Doctors in the cath lab run a line through a blood vessel and to a patient's heart to diagnose and possibly treat blockages.)
He talks about the “customers” in the system:
We're shifting the whole model. We used to build everything around what worked for the caregivers. Now we make it work for us (the hospital generally) and the patient.
Our customer is the patient and, in many cases, our secondary customer is the physician. You know, they could choose to practice anywhere. So it takes lot of work to bring physicians on board, but our physicians have stepped up. In fact, they're the reason this is working.
The article also touches on Lean methods including eliminating wasteful steps in processes and using 5S to improve organization of supplies and equipment.
Why should a nurse have to leave a patient's room to go down the hallway to get tape for the IV when we know that will be needed every time? Now every room is set up with specific supply drawers. What is stocked is uniform.