It’s Simple Things that can Fix Healthcare


Sacramento-area hospitals use simple ways to cut mistakes – Sacramento Bee

This article has some great examples and an endorsement of the Lean mindset in healthcare without ever using the words “Lean” or “Toyota.” I call this the “Like Lean” phenomenon, when you see the mindsets of Lean being put in place because it just seems like common sense.

The article says that patient harm is:

“…a serious problem with an answer that isn't necessarily high-tech, experts say.

“A computer will allow you to make a mistake faster and with greater magnitude than a paper system,” said Fran Griffin, a director at the nonprofit Institute of Healthcare Improvement, which has led several national campaigns to improve hospital safety.

Improvement happens when front-line hospital workers identify an issue and find a simple solution that can be incorporated into their daily routines.

That's a major theme in the Lean approach – not relying in technology, instead relying on the creativity of the people doing the work.

As Dr. Kim, the President of Dartmouth, said, healthcare all too often expects to find silver bullet solutions through clinical innovation — the next new drug or the next new procedure. He emphasizes that we need more focus on process.

In the article, you can read about examples of approaches that sound like visual management, error proofing, and standardized work.

On the topic of standardized work, or the lack thereof:

Between hospitals and individual caregivers, there is little standardization. As a result, medicine in practice often is more art than science. Health care workers are human and humans slip up. Griffin likens it to forgetting to attach a document to an e-mail. Except in medicine, lives are at stake.

This attitude has changed in recent years, experts say. Hospitals are now more open to low-tech solutions that might require staff to adhere to a set of rules.

Still, it's not easy. At Sutter Roseville Medical Center, every nurse had a different way of giving shift reports, which is how patients get transferred to the next shift's nurse. Nurses designed report templates on personal computers. They had special ways of folding them. Each nurse emphasized different information.

Everyone having a different way can lead to miscommunications, inefficiency, and errors.

It's great to see more hospitals approaching these kind of mindsets.

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Mark Graban is an internationally-recognized consultant, author, and professional speaker who has worked in healthcare, manufacturing, and startups. His latest book is Measures of Success: React Less, Lead Better, Improve More. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. He also published the anthology Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also a Senior Advisor to the technology company KaiNexus.

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