What’s Changed in Lean Healthcare Since 2008?
It's been three years since the first edition of my book Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement was published. The second edition came out last week and I've tried to reflect a bit on what has changed in the past three years on the Lean healthcare front. I'm also curious to hear your thoughts on this.
- There's definitely more talk of management system, not just tools and projects. Years ago, there were more questions about how to get started and what tools to use. Now, thanks to the great example of ThedaCare and other organizations, more healthcare organizations realize that Lean is about culture and management systems. Their book On the Mend and their DVD (both being projects I was involved with) set a great example for others.
- There are more case example books. When my book was published, there were other introductory overview books. But, now you have great books from leading organizations including ThedaCare, Virginia Mason, and Seattle Children's. While my book had examples and small case studies from some leading organizations, it's great to see organizations sharing their stories (successes and setbacks) in longer form.
- More people are coming from industry. While many healthcare organizations still require previous Lean healthcare experience for their positions, more hospitals and health systems are open to hiring people from other industries. These experienced Lean leaders provide fresh perspectives and new energy for being patient focused and improving care. Healthcare still has a lot of opportunities for improvement – if you're interested in helping, check out my “Move to Healthcare” online forum.
- There's more focus on quality, not just cost. At one hospital I recently visited, the CEO told a large staff gathering that “Lean is a quality system,” thanks to their site visit to ThedaCare. Pat Hagan, COO at Seattle Children's Hospital, says they never talk about cost, yet cost is going down (as a result of focusing on quality through Lean). It's true in manufacturing and it's true in healthcare, that better quality leads to lower cost. This is different than the old “cost cutting” focus.
- More organizations are focusing on daily kaizen not just events. As we document in our upcoming Healthcare Kaizen book, organizations like ThedaCare have shifted from a focus on weeklong events (“Rapid Improvement Events”) to also focus more on small daily continuous improvements. Weeklong events are fine, but they aren't sufficient for transforming an organization, as I wrote about in my article “Putting the Continuous Back in Continuous Improvement.“
- Lean healthcare is becoming even more International. Lean Hospitals is being translated into seven languages and the most frequent recent visitors to my book's website are (in order): United States, Canada, India, Sweden, Netherlands, Finland, Chile, United Kingdom, Mexico, Austria, Italy, and France, among others (about 50% of site visitors are from outside of the U.S).