ThedaCare Also Reinvents Primary Care – Patients & Doctors Win

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ThedaCare, a health system in Wisconsin, is well known for their Lean improvement system and Lean management system (“business performance system“) in their hospitals, including their innovative “collaborative care” model. recently wrote about ThedaCare's innovations in primary care delivery in this article:

Primary care case study: Quality at every step.”

One innovation that I would welcome with my own primary care physician here in Texas is getting routine lab results back DURING my visit so I can discuss them with my doctor.

2018 Update: What's Going on at ThedaCare?

My doctor's workflow:

  1. Appointment at MD office
  2. I go get blood drawn another day at another site
  3. A few days later, I get a call from the MD's office telling me about the results

With past doctors, I've had to nag them to get results, play phone tag for days, or even go back for an appointment just to get some information. Waste! Frustration!

But ThedaCare is doing it better, “with about 90% of the lab tests or imaging studies typically needed in primary care practice can be done on-site.”

This just-in-time approach to lab testing and patient care is a principal example of how physician leaders at ThedaCare have earned an outsized reputation within health care for their widespread implementation of the so-called lean-management methods that helped Toyota Motor Corp. become the world's biggest automaker. Although taking a manufacturing approach to medicine is most commonly associated with hospitals, ThedaCare is implementing the idea aggressively in primary care.

It's “patient-centered” care – and it makes you wonder, perhaps, how any healthcare could be anything but “patient centered.”

The article highlights how the efficiency improvements have gone hand-in-hand with:

  • Being ranked in the “top 3 performers” in the state for 21 of 25 quality measures
  • Better communication with patients
  • Lower physician turnover rates

As one of the ThedaCare physicians says:

“It's important to remember that this is a manufacturing process in its purest form, and health care is not manufacturing,” she said. “You have the inherent variability of patients, with all their complexities and nuances. They are not widgets; they are not cars. There's a certain point at which you have to accept that variability and that the system won't be as clean as you might like it. We shouldn't get so focused on the process that we lose sight of our mission, our goals and our professionalism.”

Yes, a doctor's office is not a car plant and a patient is not a widget. When keeping the purpose and mission in mind, healthcare organizations continue to prove they can use Lean principles and methods to improve patient care.

The article also discusses the use of daily huddles (pictured above), “Rapid Improvement Events,” and other Lean management practices. Check it out and be sure to see their photo slide show.

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. 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.



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