Most of us can easily name the biggest issues in health care outside of cost. We know the experience of waiting in a doctor’s office or emergency room. We've received medical bills for services we know are covered but are coded incorrectly. We know nurses doing their best to juggle tasks and care for patients while working a long shift. Increasingly, health organizations are looking to lean practices for ways to save time, money and become more efficient.
What is Lean?
Lean is a system designed to eliminate waste while improving value to customers. Waste is any process that does not add value to the customer, or the customer does not feel has value.
In particular, Lean methodology identifies seven wastes:
While Lean is often associated with manufacturing, hospitals and healthcare organizations can use Lean methods to eliminate waste. Some areas of healthcare efficiencies that can be created through lean practices include:
- Medical errors
- Providing workers the tools they need to serve patients and other stakeholders
- Wait times in emergency departments and offices
Reduce Patient Wait Times
Wait times are one of the biggest complaint areas for those accessing healthcare. Lean methods encourage looking for bottlenecks in processes. Solutions include moving to in-room testing instead of transporting patients around a facility and delivering test results via technology.
Administrators in the Champlain Local Health Integration system in Ontario, Canada used Lean tools to cut wait times in half by changing how they book appointments.
Administrators also eliminated transportation waste for doctors and nurses. They put a printer in every exam room, so caregivers no longer spend valuable minutes walking to printers and then delivering papers to patients. Now, those saved minutes means the next patient is seen more quickly.
Excess inventory in the form of supplies can lead to storage issues, overhead costs, and expiration dates for medications and other stock. Health care facilities can use tracking systems to understand what supplies are in high demand and order accordingly or rely on an automated order system. Adjustments can be made for emergencies or significant events such as a predicted storm.
Lean methods can help organizations better manage resources. Baxter Healthcare Corporation company held a three-day event where an interdepartmental team examined water use at its facilities. The team used a Lean tool called a value stream map to identify and eliminate waste and improve the physical plant's water use. The team implemented a plan that saved 170,000 gallons of water per day! The result was a savings of $17,000 over three months.
Medical errors are one of the number one preventable issues in healthcare today. Defects include the time spent creating the defect, correcting the defect, and preventing future defects. The names of tests, prescriptions, and diagnoses can often be similar. One way to reduce defects is to switch to a technology-based informatics system. Doctors and nurses can track patient records without relying on patient recall which may not always be accurate.
In manufacturing, overproduction is producing more products than consumers are willing to buy, resulting in excess inventory. In healthcare, overproduction includes ordering unnecessary tests, providing higher levels of care than required, or having doctors perform tasks that can be done by other qualified health care providers that charge less per encounter.
Health care settings have a flow, including where patients enter, check-in, and receive services. Movement looks at how inventory, information, and staff move between floors and departments. Designing layouts for offices and hospitals to be consistent with workflow is one way to decrease movement waste. Equipping exam rooms with the supplies mostly likely required and keeping equipment within arms-reach can also reduce movement.
Here are the ways health care organizations that employ Lean methods can benefit:
- Create a patient-centered environment
- Value contributions and ideas of employees at every level
- Eliminate or reduce patient and staff wait times
- Decrease defects in testing, diagnosing, prescribing medicine, coding, and billing
- Allow for Just-In-Time inventory systems to meet demand
- Eliminate overproduction by not providing higher levels of care than necessary, ordering unnecessary tests, and having doctors perform tasks other staff can handle effectively
- Reshapes physical movement flows in hospitals and offices streamlining the patient and staff experience
- Reduces injury to personnel through eliminating waste of motion by keeping supplies within reach and having equipment located conveniently
Learn more about how to apply lean concepts to your organization from industry leaders at Kettering University Online’s one-of-a-kind Master of Science in Lean Manufacturing.