Where Does Lean Apply in Hospitals?

Friday afternoon is a great time to call up the customers and find out what's on their minds. At Gemba we continue to benchmark with hospitals that are doing kaizen and pioneering Lean Healthcare. So last Friday I put on the headset and rang up an Administrative Director we met at a conference earlier this year. This guy heads up all the Lean efforts throughout their many locations.

I asked "If you could open up a Kaizen course catalog and find any class you wanted, what would it be?"

"Any Lean class I want? I'd want Value Stream Mapping for Healthcare." In his world, there's a big difference in the amount of care each patient requires. Some of them are deathly ill, some are ambulatory. It's critically important to be able to manage resources at hospitals according to the types of patients and the types of care they are receiving according to the healthcare Value Streams. Value Stream alignment and managing by Value Streams means organizing a cross-functional team and the required equipment and medical devices around a line of care of a particular set of patients.

The next thing he'd like to see is "Making Takt Time Meaningful in Healthcare." They continue to push for takt times in all areas, with mixed results. "When the physicians and their assistants discover that the takt time is 4.8 minutes per patient, they go ballistic. Truth is, they usually spend less time than that with patients anyway, and they just don't like to see it written down."

"How about Supply Chain issues?" I asked. He thought for a moment, and then replied, "I want to get a good kanban system in place. We have so many things that are expiration sensitive. Every time we do a 5S event, we end up throwing out lots of expired supplies, stuff that was simply used out of order. It really looks bad."

Another issue is the amount and mix of instrument sets used by surgeons. "Let's say you've got 10 surgeons doing 10 gall bladders - each surgeon will order up a different set of instruments, ranging in cost from $250 to $1800," he said, "Central Services gets a lot of those instruments back, unused." Getting surgeons to agree on a standard set of tools is not easy, but with strong leadership from the clinical side of the hospital, they have had some successes.

"Final thoughts?" I asked.

"We're looking for setup reduction in all areas. Clinical, Lab, Patient Visit Prep, everywhere. For us it's all about being ready and there's really not much in the way of Standard Work published in these areas."

So in the course of half hour conversation, we get some great ideas for classes to offer at the Lean Learning Lab. We're developing the curriculum now, and we hope to schedule several Lean Healthcare sessions early next year. Stay tuned.