Canadian healthcare organizations are increasingly asked to do more with less, and too often this has resulted in demands on staff to simply work harder and longer. Lean methodologies, originating from Japanese industrial organizations and most notably Toyota, offer an alternative – tried and tested approaches to working smarter. Lean, with its systematic approaches to reducing waste, has found its way to Canadian healthcare organizations with promising results. This article reports on a study of five Canadian healthcare providers that have recently implemented Lean. We offer stories of success but also identify potential obstacles and ways by which they may be surmounted to provide better value for our healthcare investments.
I was in the U.K. last week and saw presentations from or talked with Lean healthcare practitioners from England, Scotland, The Netherlands, Sweden, and Italy. While our payer systems and structure may be different, the waste that you see in the process and the operational details are very much the same across countries.
Virtually all healthcare systems face the same challenge: improving the quality of patient care, increasing the number of patients served and reducing wait times, while keeping spiralling costs in check. For many, it is difficult to imagine finding new opportunities to do more and better with less; yet such demands persist, and many organizations, in fact, continue to succeed.
One proven approach is Lean.
The primary motivation may be different (for example, more of an emphasis on reducing patient waiting times from referral to surgery in the UK), but the methods are pretty similar. As Ohno said, “start from need.” If quality and patient safety is your biggest problem, start there. If the problem is cost, start there (by improving quality). These issues and objectives are all pretty interconnected.
Either way, you need a “burning platform” as they say. What's yours? What can you learn from the experience of the Canadian hospitals even if you're in a different country?
Coincidentally, Paul Levy shared this on his Running a Hospital blog yesterday. This morning, I get to see Paul speak at MIT, should be interesting. He's been posting a lot about Lean recently, their efforts at Beth Israel Deaconess Medical Center, including:
- Running a hospital: 5S gets you organized to be Lean
- Running a hospital: Pig — Part 1
- Running a hospital: Interns Learn Lean — They get it in two days!
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Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation.
He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean.
Mark is also a Senior Advisor to the technology company KaiNexus.