Q&A: Implementing Lean Principles in Health Care

CHICAGO – Less is more in health care operations. In reducing nonessential practices, health care organizations can greatly increase operational efficiency for both health care staff and patients by applying lean principles. Derived from the management philosophy of the Toyota Production System, the 5 principles are based on reducing wastes to improve overall customer value. The principles are increasing in popularity throughout various markets and have made their mark in the health care industry. In this Q&A, Mani Kumar, senior consultant at Chicago-based West Monroe Partners, describes the benefits of applying lean principles to health care settings.

Q: Can you describe lean principles as they apply to health care organizations?
Kumar: Lean refers to a management philosophy originating in the automobile industry that considers any work or use of resources not adding value for the end customer as wasteful. Although different from the assembly-line style of auto manufacturing, the delivery of care to the patient is also a complex process with multiple inefficiencies. By aiming to remove or minimize these non-value-added steps, health care organizations can greatly improve process efficiency.
Q: How do lean principles benefit health care staff?
Kumar: By targeting non-value added steps, lean principles attempt to maximize the efficiency of health care staff. It cuts down on duplicate or unnecessary work, such as the creation of reports that are not even read. Another large focus of lean is to streamline processes that are deemed necessary. Evaluating factors such as the flow of patients in a hospital or the distance between supply locations and point of use, it recognizes the value of time and allows health care staff to use their time more effectively.
Q: How do lean principles benefit patients?
Kumar: Unlike some initiatives often undertaken by health care organizations, lean principles have a visible, direct effect on patients. Minimizing wasted time and redundant information gathering while streamlining other processes will have clear benefits from a service point of view. More importantly, the ultimate result of many principles is better quality of care. The lean concept of “defects” is represented by untoward outcomes such as preventable readmissions, hospital acquired infections and surgical errors. By reducing these defective “products,” patients ultimately see better results.
Q: Do lean principles reduce operational costs?
Kumar: Lean aims to reduce resources that are being used unnecessarily. Whether targeting work performed, time used or money spent, lean principles provide a tool for organizations to evaluate individual steps in the complex delivery of health care. By becoming more efficient with often-scarce resources, the end result will be a reduction in costs without a sacrifice in quality.
Q: What kinds of practices or resources are becoming obsolete in health care facilities?
Kumar: Recent policies encouraging electronic records have led to facilities naturally adopting lean practices. The widely adopted conversion away from paper-based records has helped tackle many challenges previously faced. Information is redundantly gathered less, as both patients and hospital staff have benefited from having to fill out fewer forms. Accuracy is being maintained during the coordination of care across departments, facilities and entities. This is evident in the reduction of medical errors during provider handoffs and less duplication of lab tests and exams that patients are subjected to, not to mention the fewer phone calls asking for clarification of physician handwriting.
Q: What are some of the simplest actions or changes a health care facility can make to become leaner?
Kumar: It has been proven that lean can be successful in health care but it is not something that can be done overnight and is not something to be done because it’s trendy. It can earn quick wins on a departmental level, but to be truly successful, it must be embraced as part of the organizational culture. With the support of leadership, it is necessary to learn the concepts first and then tailor-make potential improvements to your organization – you cannot simply copy what’s been done elsewhere. Additionally, adopting lean is just one potential part of the solution. Initiatives such as IT modernization and maturity of business analytics capabilities will also help reduce health care costs. It is up to organizations to evaluate themselves in an honest manner and decide what combination will yield the highest returns.