Thursday, January 19, 2012

A LEAN Approach in Healthcare – Lean Patient Centered

An Institute for Healthcare Improvement (IHI) Innovation Series white paper (2005), Going Lean in Healthcare, spells out how the principles of Lean management or Thinking can and do apply to healthcare. ( The paper includes examples from Seattle’s Virginia Mason Medical Center and northeast Wisconsin's ThedaCare, Inc.

The paper provides a brief summary of what Lean thinking or management is and where it came from. It looks at the value stream mapping approach and emphasizes how important it is to maintain our focus on the patient – the patient who defines value in our system.

Given that this paper was released in 2005, why has healthcare not embraced Lean thinking more extensively?

The paper addresses one major impediment – skepticism in the form of “we are not making automobiles, this is healthcare.” While I also believe this is an important point, I see more to our reluctance than skepticism. I believe that it is also a complex combination of “lacks” - lack of consistent leadership, lack of time, lack of money, and lack of a compelling reason to change. As long as we think we are doing an adequate job of providing service as measured by our peers, we have little motivation to make a change. And change is hard.

Yet, if we will take a look at the potential benefits of Lean thinking – improved flow, reduced costs, decreased adverse event rates, improved patient satisfaction, etc. – it makes a move to Lean practices one of the most critical steps any healthcare organization can take.

One additional reason for not jumping into Lean may be the name; Lean. While we may want to be lean ourselves, for the organization we work in we seem to prefer Fat; fat in all ways, so we think we are safer or protected in some way. We want fat or extra supplies, and the same with people ready when we need them. All of this leads to excess in our systems and processes that do not add value, value in the only terms that matter, those of the patient. Lean thinking turns this around by looking at our systems or processes with the patient answering the question: Does this add value? So while the system and processes become leaner, it is not just to satisfy a financial goal; it is to satisfy a patient goal. It is very Patient Centered – a goal we can all support by whatever we call it. Lean Thinking, Lean Management, or Lean Patient Centered

Let me know if you want to learn more about how to get a certificate in Lean Thinking.  I can offer training in conjunction with an excellent trainer.  (Send me an email: 

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