The Lean Solution
The principles of Lean Manufacturing are perfect for healthcare and optimizing processes.
Here are a number of reasons why:
1. Attainability
Lean is attainable. In other words, it does not take a PhD or MBA to use it. The tools are relatively simple to use and they emphasize harnessing the power of the people that do the work every day in the improvement initiative.
2. Urgency
Lean, if done right, creates a sense of urgency. The “Kaizen event” methodology, where you lock the people that do the work in a room for a week or two to improve the process creates a sense of needing to show results and can bring the team together in ways that just meeting once a week for months or even years cannot.
3. Incremental Improvements
Lean makes it ‘ok’ to improve incrementally. In fact, the chip away approach can continue long after the Kaizen event is completed and can be infectious, spilling over into adjacent processes.
4. Supplier Relationships
Lean looks at the processes and both the upstream and downstream “customers” and “suppliers” when developing the solution. The entire “value stream” from inception of the process to the end result must be looked at collectively with the constituents from those “customer” and “supplier” groups involved in the solution. For example, if you are looking at reducing credits issued, you need to think about why a credit happens and involve those upstream functions and downstream “customers” in the process in order to optimize it. It could be that the cause of the credit can be completely eliminated upstream if someone in another department just does something differently. Or perhaps the process can be improved by changing a requirement of the Accounts Payable department that processes the credit and issues the refund. Simply looking at the credits process in a vacuum, will most likely, eliminate possible solutions. Potentially, this approach will discard the best and most impactful ideas and solutions from consideration because those groups are not represented at the table.
5. Cultural Transformation
As a service industry, much of what is done in healthcare is done by people, for people and with people. A poor or negative culture can make or break these exchanges. Lean helps build a positive culture. I once worked with a hospital system using Lean to improve the Revenue Cycle and when we started, the environment was quite negative. People thought change would never happen and that their input did not matter. We began an approach to chip away at high priority problems, using the Lean-based incremental approach. The chipping away progress helped transform the cultural tenor of the team and that revenue cycle operation has continued to experience a positive team atmosphere even long after our team left. Where the Revenue Cycle team was once viewed as a hindrance to organizational success, the cash being collected is now fueling new investment. A portion of this success was a result of this cultural transformation from “it won’t work here” to “we can do this” that the Lean effort nurtured.