Implementing Lean in Healthcare
Organizations
Methods and Results
John Beakes, Jr.
President and CEO
Operational Performance Solutions, Inc.
Denver Health
Results from
Lean, 2006-2011
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Dr. Berwick on Lean
“If you doubt that we know what to do, visit Denver
Health or ThedaCare or Virginia Mason,
and see the Toyota principles of lean production
learned, mastered, adapted, and deployed
through entire systems and into the skills and
psyches of entire workforces.
The result, over $100 million in savings at Denver
Health while vastly improving the experience and
outcomes of patients.”
Observation from Donald M. Berwick, MD at the Keynote Presentation at IHI’s 23rd Annual National Forum on Quality Improvement in Health Care
December 7, 2011
Orlando, Florida
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Transformation Has Two Elements
Technical and Social
Pursuit of Perfection
Value Stream Thinking
Disconnected Process
Improvement
Social
Tools and Techniques
The Path to Lean
Technical
Tools and Techniques
Learning Organization
Advanced Teambuilding
Employee
Empowerment
Tools Deployment
Employee Engagement
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Quality
“True North”
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Quality
“True North”
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Lean Deployment Guide
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Healthcare People “Get” Lean
• Healthcare is the diagnosis and treatment of
illness
• Lean is the diagnosis and treatment of
processes
• The goal is to give healthcare professionals a
new way to look at their processes using a
small Lean toolset
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Lean System Models
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Denver Health
Results from
Lean, 2006-2011
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Ref: Going Lean In Healthcare. Institute for Healthcare Improvement. 2005
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A Medical Center Management System Model
Medical Center
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Benefits of a System Model
• Provides an integrating framework
• Clarifies system interactions
• Facilitates communications
– Embodies “the story”
• Promotes consistency of purpose
• Enhances new employee training
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Benefits of a System Model
• Provides an integrating framework
• Clarifies system interactions
• Facilitates communications
– Embodies “the story”
• Promotes consistency of purpose
• Enhances new employee training
KEY TO SUSTAINMENT
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Quality
© Copyright 2008-2012. Operational Performance Solutions, Inc.
“True North”
PDCA
Mistake Proofing
Continuous Flow
Pull Systems
5S/Visual Management
Standard Work
The Lean System of Patient Care
Principles
Objectives
Patient Centered
Quality at the Source
Standard Processes
Engaged Employees
Pursuit of Perfection
Supplier Partnerships
Defect Free
Without Waste
Just-in-Time
Continuous Flow
Continuous Improvement
Leadership Commitment and Support
Go See Ask Why Show Respect
- Culture Centered on Patient Care
- Employee Engagement
- Servant Leadership (EPIC)
- Cascading Annual Planning Process
Quality
“True North”
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Quality
“True North”
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Quality
© Copyright 2008-2012. Operational Performance Solutions, Inc.
“True North”
PDCA
Mistake Proofing
Continuous Flow
Pull Systems
5S/Visual Management
Standard Work
The Lean System of Patient Care
Principles
Objectives
Patient Centered
Quality at the Source
Standard Processes
Engaged Employees
Pursuit of Perfection
Supplier Partnerships
Defect Free
Without Waste
Just-in-Time
Continuous Flow
Continuous Improvement
Leadership Commitment and Support
Go See Ask Why Show Respect
- Culture Centered on Patient Care
- Employee Engagement
- Servant Leadership (EPIC)
- Cascading Annual Planning Process
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Quality
© Copyright 2008-2012. Operational Performance Solutions, Inc.
“True North”
PDCA
Mistake Proofing
Continuous Flow
Pull Systems
5S/Visual Management
Standard Work
The Lean System of Patient Care
Principles
Objectives
Patient Centered
Quality at the Source
Standard Processes
Engaged Employees
Pursuit of Perfection
Supplier Partnerships
Defect Free
Without Waste
Just-in-Time
Continuous Flow
Continuous Improvement
Leadership Commitment and Support
Go See Ask Why Show Respect
- Culture Centered on Patient Care
- Employee Engagement
- Servant Leadership (EPIC)
- Cascading Annual Planning Process
Leadership Commitment and Support
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Leadership Commitment and Support
Go See Ask Why Show Respect
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Leadership Commitment and Support
Go See Ask Why Show Respect
•
•
•
•
Culture Centered on Patient Care
Servant Leadership (EPIC)
Employee Engagement
Cascading Annual Planning Process
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Principles
• Patient Centered
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Value Stream Thinking
and
Organizational Structure
Hospital Floor
Imaging
Radiology
LAB
Pharmacy
ED
Hospital Floor
Imaging
Radiology
LAB
Pharmacy
ED
Hospital Floor
Imaging
Radiology
LAB
Pharmacy
ED
Performance Review; Professional Recognition; Promotions
Hospital Floor
Imaging
Radiology
Patient
LAB
Pharmacy
ED
Performance Review; Professional Recognition; Promotions
W= WASTE
W
W
W
Hospital Floor
Imaging
Radiology
Patient
LAB
ED
Pharmacy
Performance Review; Professional Recognition; Promotions
W
W
Hospital Floor
Performance Review; Professional Recognition; Promotions
W= WASTE
W
Imaging
Radiology
Patient
LAB
ED
Pharmacy
Value Stream Analysis Process
W
W
W
W
Principles
• Patient Centered
• Quality at the Source
• Standard Processes
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Standard Work Chart &
SPD Lead Checklist
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Principles
• Patient Centered
• Quality at the Source
• Standard Processes
• Engaged Employees
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Medication Sorting
After ----->
Medication Sorting
<----- Before
After ----->
Principles
• Patient Centered
• Quality at the Source
• Standard Processes
• Engaged Employees
• Pursuit of Perfection
• Supplier Partnerships
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Objectives
• Defect Free
• Without Waste
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Current Rounds made by a Floor RN
Roaming Supply Cart
• Frequently needed
supplies are stored in
drawers.
• Dietary items (i.e.
spoons, applesauce,
straws, thickener) are
located in drawers
separate from the
linens.
Objectives
• Defect Free
• Without Waste
• Just-in-Time
• Continuous Flow
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Decontamination
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Decontamination
Before
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After
Objectives
• Defect Free
• Without Waste
• Just-in-Time
• Continuous Flow
• Continuous Improvement
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Continuous Improvement









Lower the water level
Find rocks
Remove them
Lower the water level
Find new rocks
Remove them
Lower the water level
Etc., etc…
Seek perfection
(a never-ending process)
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Denver Health
Results from
Lean, 2006-2011
52
Quality
© Copyright 2008-2012. Operational Performance Solutions, Inc.
“True North”
PDCA
Mistake Proofing
Continuous Flow
Pull Systems
5S/Visual Management
Standard Work
The Lean System of Patient Care
Principles
Objectives
Patient Centered
Quality at the Source
Standard Processes
Engaged Employees
Pursuit of Perfection
Supplier Partnerships
Defect Free
Without Waste
Just-in-Time
Continuous Flow
Continuous Improvement
Leadership Commitment and Support
Go See Ask Why Show Respect
- Culture Centered on Patient Care
- Employee Engagement
- Servant Leadership (EPIC)
- Cascading Annual Planning Process
The Key Processes for Lean Healthcare
• A3 Problem Solving
• Value Stream Analysis Process
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Quality
© Copyright 2008-2012. Operational Performance Solutions, Inc.
“True North”
PDCA
Mistake Proofing
Continuous Flow
Pull Systems
5S/Visual Management
Standard Work
The Lean System of Patient Care
Principles
Objectives
Patient Centered
Quality at the Source
Standard Processes
Engaged Employees
Pursuit of Perfection
Supplier Partnerships
Defect Free
Without Waste
Just-in-Time
Continuous Flow
Continuous Improvement
Leadership Commitment and Support
Go See Ask Why Show Respect
- Culture Centered on Patient Care
- Employee Engagement
- Servant Leadership (EPIC)
- Cascading Annual Planning Process
Building a True Lean Culture
• Means winning “one heart and soul at a time”
• Each individual comes to a full commitment at
their own individual pace
• Be patient - some who embrace it slowly
become the strongest advocates
• You know you’re there when all employees
engage in identifying and eliminating waste
every day
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Quality
“True North”
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Quality
“True North”
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Quality
© Copyright 2008-2012. Operational Performance Solutions, Inc.
“True North”
PDCA
Mistake Proofing
Continuous Flow
Pull Systems
5S/Visual Management
Standard Work
The Lean System of Patient Care
Principles
Objectives
Patient Centered
Quality at the Source
Standard Processes
Engaged Employees
Pursuit of Perfection
Supplier Partnerships
Defect Free
Without Waste
Just-in-Time
Continuous Flow
Continuous Improvement
Leadership Commitment and Support
Go See Ask Why Show Respect
- Culture Centered on Patient Care
- Employee Engagement
- Servant Leadership (EPIC)
- Cascading Annual Planning Process
Denver Health
Results from
Lean, 2006-2011
62
Contact Information
Operational Performance Solutions, Inc.
77 East Main Street, Suite 402K
Westminster, MD 21158
(410) 871-0995
info@OPSgroupinc.com
www.OPSgroupinc.com
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