Lean Management Strategies for Healthcare
“Lean manufacturing” took off in the early 1990s as companies tried to emulate Toyota’s efficiency-boosting processes. The philosophy’s tenets of continuous improvement through incremental change are meant to improve quality, bring teams together and ultimately improve the bottom line. It’s not as common in the healthcare industry, although healthcare’s shift to outcome-based care over volume-based care has inspired leaders to look at different improvement strategies, including Lean.
The results can be impressive. “We’ve seen falls reduced by 50 percent in one area, infection rates reduced by 50 percent in some areas, throughput time reduced by 40 percent,” says Skip Steward, Chief Improvement Officer at Baptist Memorial Health Care in Memphis, Tennessee. “Lean absolutely translates from manufacturing to healthcare by looking at purpose, people and processes.”
Thinking about Lean at your organization? Here’s what you need to know.
Set the Right Goals
Under Lean management, the organization moves toward a goal; once that goal is reached, a new goal is set. It’s important to remember, however, that “cost cutting” isn’t a useful goal to set, says Beau Keyte, President of Keyte Group, a business consulting agency. Lean goals need to be something that people can care about, and in healthcare, that often centers around patients.
Reducing mistakes, increasing the number of home hospice visits with existing staff or lowering the incidents of people who use the emergency department for preventive care can give everyone something specific to focus on, Keyte says. Results from these goals could include better care, satisfied patients, happier staff, reduced waste and lowered costs.
Establish Buy-In from All Levels of the Organization
One of the tenets of Lean management is getting everyone in the organization to buy into the process and to be willing to be held accountable for results. Above all, everyone who is affected by potential change should be in on the planning, Keyte says. “Relying only on a small team of caregivers still has its bias: They don’t see things the way others might,” he says.
Be deliberate in seeking out different perspectives from co-workers. Doing so will not only help create a more robust solution but will get better buy-in because everyone will see that their perspective has been acknowledged, he says. “Rely on the experts, the people who do the actual work, to do the thinking and redesign of the work, as opposed to internal or external consultants who don’t have to live with the consequences and don’t really understand the work,” he says.
Equip and Train Everyone to Understand the Data
Data plays a major role in Lean initiatives. While healthcare organizations generate a lot of clinical data, Keyte says, providers may be more unfamiliar with dealing with procedural or process data and reports. In addition, “Everyone relies on reports, but the reports rarely point to specific areas with enough information to successfully intervene,” he says. And technical limitations may make it difficult for different systems to communicate.
Because analyzing data is so important in Lean initiatives, your organization may need to change the way it collects, stores, analyzes and shares data. That means ensuring everyone has the right tech tools, knows how to use them and is looking at the right data to make change.
Build a Learning Culture
One of the challenges of establishing Lean management in healthcare is that providers are used to being right. “They’re brilliant, but they’re the ultimate decision-makers who are trained to fix and solve problems,” says Mary Grace Gardner, Director and Chief of Staff at a hospital system as well as Founder of The Young Professionista consulting agency. If they stick to the old ways of doing things and resist improvement, your Lean management initiative could fail.
Stress the importance of innovation and learning under the Lean initiative. “In Lean, it’s okay to make mistakes and it’s expected to some extent,” Gardner says. “It’s different from what they’re used to, but it’s okay to be transparent about not knowing the answers.” Communicating that message consistently will encourage people to innovate.
Prepare for Upheaval
Lean isn’t for everyone, and some of your employees may self-select out of your change initiative. Some turnover isn’t uncommon, Gardner says. “You’ll always have early adopters and champions, but others are wedded to the traditional way of doing things and they won’t thrive,” she says. “Turnover is very common in transformation, especially if it’s a full system or hospital. But sometimes that’s what you need.”
Lean management can bring major changes to your organization, but only if you implement it correctly. However, its focus on continuous improvement and collaboration can be a good fit for many healthcare organizations.