Mark's note: Today's guest post is Tim Piotrowski from AME – the Association for Manufacturing Excellence. Their annual conference is being held in Dallas in October. I'll be attending on Thursday and will be teaching an optional workshop on “Kaizen: Continuous daily improvement for health care and services” on Friday morning. I hope to see you there. Use code HC2016″ to receive a $100 off your registration.
By Tim Piotrowski
A few years ago, before I'd ever been aware of Lean healthcare, I spent a considerable amount of time at the hospital and in doctors' offices. I was not sick and I didn't work in healthcare. At the time, I was a freelance marketing professional who was primary caregiver for my mother, who spent two months in the hospital battling late stages of heart failure.
During those emotional, stressful moments, it was difficult to get much of my work done. However, I was endlessly fascinated by the activities of the doctors, nurses, administrators, and staffers. So, in the middle of my emotional journey, I spent considerable time listening and observing.
I knew that the doctors and the staff were doing their best to give my mother the best care possible.
But, there were moments when I saw opportunities for improvement and I witnessed many of the eight wastes of Lean healthcare, outlined by Dr. John Toussaint in his book, On the Mend:
- Defects: Making errors, correcting errors, inspecting work already done for error
- Waiting: For test results to be delivered, for an appointment or for a bed, for release paperwork
- Motion: Searching for supplies, fetching drugs from another room, looking for proper forms
- Transportation: taking patients through miles of corridors from one test to the next unnecessarily, transferring patients to new rooms or units
- Overproduction: excessive diagnostic testing, unnecessary treatment
- Overprocessing: a patient being asked the same question three times, unnecessary forms; nurses writing everything in a chart instead of noting exceptions
- Inventory (too much or too little): overstocked drugs expiring on the shelf, under-stocked surgical supplies delaying procedures while staff goes in search of the needed items
- Talent: failing to listen to employee ideas for improvement, failure to train technicians and doctors in new diagnostic techniques
Each trip to the doctor's office was an adventure. It wasn't unusual to spend an hour in the waiting room for her primary care physician to arrive, only to be whisked out quickly once she did get a chance to see him. In instances like these, I felt that my mother was getting cheated and her time was being wasted.
In the hospital, my mother spent time on different floors and different units, depending on the severity of her condition. Each time she transferred floors, I'd see nurses fumbling through a large file folder of information, yet they seemed clueless about what was happening with her in the moment. It wasn't unusual to see confused expressions from the nurses about the medication she was taking. I often repeated the latest story to the new team of nurses to provide some context.
I also found that her quality of care was very inconsistent overall. On certain floors, the nurses seemed on top of their game, on other floors they were barely visible.
I'll never forget the time she called me in tears from her hospital room asking me to stop by to help her…she had called for a nurse to help her get up to go to the bathroom and it had been nearly an hour — she was still waiting for help. During moments like these, it was obvious that the hospital had some serious flaws in its process and in the way it served its patients.
I've been fortunate to witness a healthcare organization that practiced Lean. What really stood out to me was how efficient it was and how much the employees loved their work environment. This employee happiness positively impacted the interaction with the patients.
At the 2016 AME International Conference in October, there are opportunities to learn from healthcare organizations applying Lean and continuous improvement principles at their workplace. One of these organizations is Intermountain Healthcare in Salt Lake City, which utilizes seven key systems to support continuous improvement at its hospitals. Another organization, Signature Healthcare in Brockton, MA, made the decision to put the needs of the patient first as they implemented Lean from a ground up management system across all departments within the hospital.
In Dallas, you'll have the opportunity further your organization's Lean journey by learning from healthcare organizations implementing Lean and continuous improvement through engaging presentations, tours and workshops. If you're a healthcare professional, be sure to use the code “HC2016” to receive a $100 off your registration.
As I learn about organizations applying Lean and continuous improvement principles, it comforts me in knowing that these principles are not only making operations more efficient, but also creating an environment where patients and their families are having a better overall experience.
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