FEATURES
control and cut costs strategically across all
Reengineering
Workflows
functional areas of an organization. One of
the biggest opportunities to realize a positive
financial impact is improving the efficiency of
These strategies will help you lean out your operations.
By Charles Hagood
operations within a hospital’s walls. The implementation of Lean methodologies and process
improvement initiatives are excellent ways of
achieving efficiencies and reducing care delivery costs across an organization’s care continuum. These initiatives strive to improve not
only processes, but outcomes as well.
The core idea behind Lean is to strengthen
processes by distinguishing value-added steps
from non-value added ones and eliminating that wasted effort. When applied within
healthcare organizations, Lean principles can
have a significant effect on productivity, cost
and quality of outcomes. While an increasing
number of hospitals and health systems are
adopting Lean concepts to address declining reimbursements and shrinking margins,
many organizations struggle with effectively
implementing Lean programs. The American Society for Quality conducted a study of
77 hospitals and found that 53 percent have
he Affordable Care Act and val-
T
some type of Lean initiative, but that only 4
ue-based payment structures make it
percent have fully deployed Lean, from man-
imperative to shift organizational focus
agement to the frontline.1
to outcomes over procedures and prevention
One of the deciding factors in achieving an
over treatment. At the same time, declining
effective Lean deployment is understanding
reimbursement make it imperative to figure
that Lean is more than a set of tools - it is a
out effective ways to strengthen operational
modification in both behavior and culture.
April 23, 2013
I www.advanceweb.com/executiveinsight I
EXECUTIVE INSIGHT
FEATURES
EXECUTIVE BUY-IN
leadership operating system creates a collaborative culture
Commitment from upper management is step number one
where everyone, from the executive suite to the front line,
in achieving a successful Lean transformation. Support from
works together to continuously improve care delivery.
understand the importance of Lean principles and feel em-
HOSPITAL-WIDE CULTURE
powered to make lasting changes to improve operations both
An understanding that Lean principles take time to disperse
within their departments and the organization as a whole.
throughout an organization also is critical. It’s important to
Lean process improvement requires a fundamental shift in
encourage positive staff commitment as Lean principles are
how the hospital operates, from the board room to the front
incorporated into everyday work but also to be mindful that
line. As training occurs throughout the organization, the ex-
a sweeping change in culture requires time and ongoing re-
ecutive team assumes a new role. They follow the journey of
inforcement. Lean is focused relentlessly on both objectives
the patient (or value stream) and observe how information,
and means. Reliable processes designed to minimize waste
supplies and people flow through the system from the mo-
and make it easier to do the right things every time will help
ment the patient is admitted until he or she is discharged.
the organization reach its objectives for improved efficiency,
The result: Patient and worker satisfaction scores continue to
client and patient satisfaction, and quality of care.
rise, quality measures improve and cost savings continue to
The bottom line: Leaders who actively live Lean principles in
accrue. Leaders no longer worry about “sustaining” the effort
their own work help to establish the hospital-wide culture. Only
because Lean is, simply, the way they do business.
then will Lean no longer be considered a fad or a “program,” but
will become ingrained within the culture and mindset of the
LEADERSHIP OPERATING SYSTEM
organization. In the words of Lucian Leape, “It’s the way we do
A realistic and comprehensive understanding of what Lean can
things around here.”2 The culture of Lean begins at the top.
truly do for an organization is the next step in successfully deploying a Lean initiative. A common belief is that Lean is only a
References
set of tools such as a Kaizen event or a 5S event. But, Lean is not
1. ASQ Lean Six Sigma Hospital Study Advisory Committee. Get Your Checkup: ASQ
a problem-solving “project” to be delegated to staff members in
study looks at hospital deployment of lean and Six Sigma. August 2009. http://asq.
the quality department. While consultants and teachers can be
org/perl/search-Google-Mini.pl?q=cache:8nXEL4Er1Hg:http://asq.org/quality-prog-
helpful, especially in jump-starting the initial effort and offering
more information as the initiative advances, a Lean transfor-
ress/2009/08/six-sigma/get-your-checkup.pdf+lean+hospital&site=my_collection&output=xml_no_dtd&client=my_collection&access=p&proxystylesheet=my_collection&oe=UTF-8. Accessed June 12, 2011.
mation cannot be outsourced. It must be led, and lived, from
2. Lucian Leape, address to Pittsburgh Regional Healthcare Initiative, September 2004.
executive management and down through the ranks.
It helps to think of Lean as a “leadership operating system,”
running in the background of the hospital at all times. This
EXECUTIVE INSIGHT
I www.advanceweb.com/executiveinsight I
Charles Hagood, president and founder, Healthcare Performance
Partners, a MedAssets Company.
April 23, 2013
©2013, Reprinted with permission from Merion Matters, Publishers of ADVANCE Newsmagazines. ADVANCE Reprints 1-800-355-5627, ext 1484.
executive leadership will help to ensure that staff members