Lean Healthcare Archives - 6sigma

Patient Safety Awareness Week Mar 11- 17

OpEx Learning Team — Fri, 28 Feb 2025 06:14:21 +0000

Patient safety practices have been defined as those that reduce the risk of adverse events related to exposure to medical care across a range of diagnoses or conditions. This definition is solid, but quite incomplete, because so many practices have not been well studied with respect to their effectiveness in preventing harm. However, the one fact we understand is the direct relationship between quality improvement practices and patient safety.

This week, our healthcare professionals are celebrating Patient Safety Awareness week. This is an annual opportunity to bring together healthcare professionals and patients in an effort to provide the highest quality and safest delivery of healthcare possible. Healthcare professionals are very familiar with the alarming and frequently cited statistics from the Institute of Medicine. Medical errors result in the death of between 44,000 and 98,000 patients every year. These numbers remind us that quality improvement and patient safety efforts must continue to be foremost in their daily practices.

Healthcare institutions and professionals are exploring innovative approaches and methods that reduce preventable medical errors, improve patient care and safety and decrease healthcare costs. Increasingly, healthcare institutions are implementing lean operational principles and practices pioneered at Toyota and other industrial companies. Lean is a cultural transformation that changes how an organization works. No one stays on the sidelines in the quest to discover how to improve the daily work. It requires new habits, new skills, and often a new attitude throughout the organization from senior management to frontline service providers.

Lean is a journey, not a destination. Clinical and nonclinical staff members who are given the encouragement, training, and time to make meaningful improvements in how the work is done are unlikely to want to retreat to an earlier period when formalized efforts to improve existing processes were outside their control. When staff members gain confidence in their problem solving skills and they see positive changes, momentum for even more improvement will build.

By applying lean methodologies to existing systems and procedures, major healthcare institutions are achieving significant improvements in patient safety while also reducing costs.

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[VIDEO] Patient Safety Week 2018

OpEx Learning Team — Fri, 28 Feb 2025 06:14:20 +0000

When speaking about patient safety, the conversations are really about how hospitals and other healthcare organizations protect their patients from errors, injuries, accidents, and infections. While many hospitals are good at keeping their patients safe, some hospitals aren’t. It’s up to everyone to make sure that patient safety is the number one priority at every hospital across the United States.

Take the time to watch these educations videos about patient safety.

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[VIDEO] Lean Six Sigma Approaches in Healthcare

OpEx Learning Team — Fri, 28 Feb 2025 06:14:07 +0000

Lean principles have been used in manufacturing for decades. We know that lean principles can be successfully applied to the delivery of healthcare. Although healthcare differs in many ways from manufacturing, there are also significant similarities. Patient care professionals must rely on multiple, complex processes to accomplish their tasks and provide value to the customer or patient.

Check out this informative MIT video on the Lean methodology in healthcare.

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Healthcare: Improving Quality and Innovation With Lean Principles

OpEx Learning Team — Fri, 28 Feb 2025 06:14:06 +0000

No other industry places such a high a premium on quality of service as healthcare. Given the essential requirement of quality in the healthcare industry, consumers expect providers to lead the way in innovation and quality efforts in the services they provide. As a percentage of its gross domestic product (GDP), we spend more on healthcare than any nation in the world. In a study conducted by the Institute of Medicine, preventable medical errors are estimated to result in as many as 98,000 patient deaths each year, with a projected annual cost as high as $29 billion. These errors are believed to be one of the leading causes of death in the US. There has never been a more ripe environment for the innovative and quality improvement methods of lean practices.

Healthcare institutions are implementing lean principles and practices pioneered at Toyota and other industrial companies. The industry is currently undergoing an unprecedented change, as providers are engaged in efforts to bring their practices into compliance with the requirements of the 2011 Patient Care and Affordable Care Act. As a result, healthcare providers are under significant pressure to increase access and reduce costs while improving the quality of patient care. Because of these significant pressures, the industry is seeking innovative ways to improve quality of service and reduce costs. Lean principles and practices are now being implemented in medical environments. We know that Lean offers significant advantages over other quality improvement models by increasing efficiency and reducing waste while simultaneously improving quality of patient care.

Lean practices and principles have the potential to help balance the cost associated with healthcare, increase the job satisfaction of professionals, and fundamentally improve the health of our communities. In the current environment, there has never been a more crucial time for healthcare to operate in the most efficient manner possible, while delivering the highest quality care in a safe manner.

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[VIDEO] The Eight Types of Waste in Healthcare

OpEx Learning Team — Fri, 28 Feb 2025 06:14:03 +0000

Introducing lean thinking in an organization must be a whole-system strategy. Those at the very top of the organization must lead it. It requires significant change management throughout an entire organization, which can be traumatic and difficult. Strong commitment and inspiring leadership from senior leaders is essential to the success of an effort this challenging. One of the challenges of implementing lean in healthcare is that it requires people to identify waste in the work in which they are so invested. All workers want to feel their work is valuable, perhaps most especially healthcare workers. Recognizing that much about their daily tasks is wasteful and does not add value can be difficult for healthcare professionals.

Mark Graban is an internationally-recognized consultant, author, keynote speaker, and blogger. Watch this educational video by Mark on the eight types of waste in healthcare.

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Lean Thinking – Advancing Efficiencies in Healthcare

OpEx Learning Team — Fri, 28 Feb 2025 06:14:02 +0000

For the past decade, healthcare has been the focus of a spirited campaign of debate in America. Both sides of the argument have focused on how best our healthcare would be delivered. Today, the debate rages on, but the core problems that truly affect a system continue to hurt those in need. The true need in healthcare reform is to improve operational efficiencies. Neither side is looking at the core issues of wait times, capacity or cost. These three elements are what plague the system today. Spend some time in any healthcare facility in this country, and you will see the signs of our issues. Patients stack up in waiting rooms for hours to receive a service that takes 10 minutes to deliver.

Lean Innovation Partnership in Healthcare

Up to this point, we have traditional methods of improvement, such as Lean or Six Sigma and have achieved modest results, which are slow in coming. With today’s modern technologies, we are at a crossroads for massive innovation and real change — specifically, with digitized patient data, machine learning AI, IoT real time data, predictive analytics, cloud infrastructure and smartphones. These elements come together and present a unique opportunity, especially when combined with lean thinking. Healthcare is an environment of a complex network of interdependent units operating individually to deliver care. Understanding the true operational function of these units, then bringing them together as a functioning unit that operates at a maximum level of efficiency is the true path to improvement.

Focusing on using sophisticated lean methodologies, combined with data science, plus machine optimization can significantly improve the efficiency of our system. It will significantly improve efficiencies, reduce wait times and costs in a system that right now is not providing the absolutely the best and most innovative level of care possible.

Read more about healthcare improvement opportunities here along with a perspective on Lean healthcare here.

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Lean Healthcare – Spend Some Time with Mark Graban

OpEx Learning Team — Fri, 28 Feb 2025 06:07:29 +0000

Mark Graban is an internationally recognized leader in Lean healthcare and continuous improvement. His motivation is to apply Lean and Toyota Production System principles to improve quality of care and patient safety, to improve the customer-patient experience, to help the development of medical professionals and employees, and to help build strong organizations for the long term.

Lean management principles have been used effectively in manufacturing companies for decades. Those same principles can also be successfully applied to the delivery of healthcare. Lean healthcare begins with driving out waste so that all work adds value and serves the customer-patient needs. Identifying value added and non-value added steps in every process is the beginning of the journey toward success.

Although Lean healthcare differs in many ways from manufacturing, there are also surprising similarities. Whether building a car or providing healthcare for a customer-patient, workers must rely on multiple, complex processes to accomplish their tasks and provide value to the customer or patient. Waste of money, time, supplies, or good will always decreases value.

Check out this educational video from Mark Graban.

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Lean Management: An Interview on Implementation at CCBRT

OpEx Learning Team — Fri, 28 Feb 2025 06:05:55 +0000

Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) was established in 1994 as a Community Based Rehabilitation program, working with people with searching cataracts in Dar Salaam. Since its inception, they have grown to become the largest indigenous provider of disability services in Tanzania. CCBRT is a locally registered NGO aiming to empower people with disabilities and their families, improve their quality of life, and ensure access to medical and rehabilitative treatment. CCBRT is committed to preventing disabilities wherever possible. They are also engaged in extensive maternal and newborn healthcare (MNHC) activities.

Implementing Lean Management

In 2012, Michael Grogan introduced the principles of Lean Management to CCBRT. In this interview Suzan Boon, Deputy CEO of CCBRT, discusses the opportunities and challenges of implementing Lean Management within their healthcare facility.

Suzan was very energized with the implementation of the practice. She was encouraged to see results happening in just a few short weeks. Her impressions were that issues that were embedded in the organization were quickly coming to light, and the communication flow between the top and bottom of the organization was significantly increased. Susan felt strongly that Lean Management is allowing CCBRT to get more structure within the organization and quickly increase efficiencies.

Take a few minutes and view this video on CCBRT.

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Lean Healthcare: Making a Case for Change

OpEx Learning Team — Fri, 28 Feb 2025 06:05:54 +0000

Lean management principles have been used effectively in manufacturing companies for decades, particularly in Japan. Lean thinking begins with driving out waste so that all work adds value and serves the customer’s needs. Identifying value added and non-value added steps in every process is the beginning of the journey toward lean operations. In order for lean principles to take root, leaders must first work to create an organizational culture that is receptive to lean thinking. The commitment to lean must start at the very top of the organization, and all staff should be involved in helping to redesign processes to improve flow and reduce waste.

Adapting Lean Healthcare

Lean healthcare differs in many ways from manufacturing, but there are also surprising similarities: Whether building a car or providing healthcare for a patient, organizations must rely on multiple, complex processes to accomplish their tasks and focus on the value to the patient.

Introducing lean healthcare in an organization is a major challenge. It cannot be done piecemeal, but must be a whole-system strategy. There is no single silver bullet solution that will achieve the same results. And it cannot be done only by middle managers or frontline workers. Those at the very top of the organization, in the C-suite, must lead! Implementing lean healthcare requires major change management throughout an entire organization. A strong commitment from the C-suite is essential to the success of an effort this challenging. The CEO must be a vocal, visible champion of lean healthcare!

Innovation and visionary healthcare organizations are leading the way by demonstrating that lean healthcare can reduce waste with results comparable to other industries. Leaders in healthcare organizations must emphasize the importance of creating an organizational culture that is ready and willing to accept lean thinking.

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Quality Healthcare: Can Process Improvement Really Work in Healthcare?

OpEx Learning Team — Fri, 28 Feb 2025 06:05:51 +0000

In God we trust¦and all others must bring data.

Dr. William Edwards Deming

Quality improvement concepts and techniques, such as Six Sigma and Lean practices, have been used to transform almost every major industry in the world with dramatic results. The last holdouts, the last passions of resistance, are primarily healthcare, higher education, and government. Healthcare professionals will take clear data and twist it just enough to make an argument, or they simply will refuse to accept the data being presented. Some will tell you that they are a skilled healthcare practitioner and simply will not be told how to deliver quality healthcare to patients by someone who possess the name of a karate belt in their job title.

The question is why does healthcare continue to resist the results presented from other industries and their significant success?

Can We Ever Have Real Quality Healthcare?

It just seems that no matter how much data can be thrown on the table, quality healthcare practices continue to be resisted like a despotic dictator. We all can acknowledge healthcare is very complex, but it’s really not fundamentally different from other industries. Healthcare is really made up simply of thousands of interlinked processes that result in a very complex system. If we focus on the processes of care one at a time, we can fundamentally change the game and deal with the challenges facing healthcare. We also understand Pareto’s Principle, which tells us 20% of the processes that will give us 80% of the results.

In healthcare, the real problem remains in two familiar circles. The first is silos. Healthcare is deeply entrenched in its divisions. Each group feels that they are doing a great job, and present arguments that the others are really responsible for making the changes required to find quality healthcare. This leads to back-and-forth finger pointing and blame games. Nursing will tell you that the problem is the physicians, and physicians will tell you that nursing is the group that needs to shape up. Then, you will hear from physicians and nursing that if you really want to improve quality healthcare initiatives, you must fix support services or even worse, the patients are at fault. They are the real problem.

The second challenge that faces quality healthcare initiatives is leadership support. C-suite executives are more than hesitant to challenge physicians or nursing on clear issues within their control. Physicians bring in significant amounts of revenue to the organization and could cripple a healthcare facility if they moved on. Nursing ensures care is delivered and is on the front line of quality healthcare. They will tell you that things work just fine using the same procedures and processes that have been in place for years. C-suite executives tend to shy away from powerful and strong-willed nursing departments.

Continuing on the Road to Quality Healthcare

There are numerous organizations that can clearly demonstrate significant levels of success in quality healthcare improvement. Just as many continue to resist embracing the practice, others implement Six Sigma and Lean programs, with a ‘nod and wink’, taking on easy projects that don’t stop on toes of the powerful in the organization. It continues to baffle how a healthcare organization can have Lean Six Sigma programs in place for years and fail a Joint Commission survey because of serious quality issues.

There is a long road ahead for all.

Do you think things are changing in healthcare, or is there still some major resistance?

Check out our other Lean Healthcare articles and videos >>>

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Lean Healthcare: Making the Most in a Challenging Environment

OpEx Learning Team — Fri, 28 Feb 2025 06:05:50 +0000

In today’s challenging healthcare environment, improving quality and efficiency, while controlling costs are more important than ever to the success of the industry. Government regulations associated with the Affordable Care Act (ACA) and rising costs of services are significantly stretching healthcare organizations. With the increasing administrative burdens, healthcare organizations look immediately to cutting costs across the board. Staffing is a major expense and typically is the first focus for change.

Lean Healthcare Drives Efficiencies

Over the past ten years, healthcare cases reveal that Lean Healthcare practices are as applicable in complex healthcare environments as Lean practices are in assembly-line manufacturing. When well executed, Lean Healthcare practices transforms how an organization thinks and works, creating an insatiable quest for improvement.

Lean Healthcare practices are a cultural shift that changes how a healthcare organization thinks and works; no one stays on the sidelines in the quest to discover how to improve the daily work. It demands new habits, new skills and often a new attitude throughout the organization from senior management to frontline service providers. Creating a culture of Lean in healthcare is to create an insatiable appetite for improvement.

To maximize value and eliminate waste, healthcare organizations, as in other organizations, must evaluate processes by accurately specifying the value desired by the user; identifying every step in the process and eliminating non-value added steps and making value flow from beginning to end based on the expressed needs of the patient.

A major principle in the application of Lean Healthcare practices is to eliminate the amount of time currently spent on non-value added activities in the delivery of the highest quality of patient care. In other words, by identifying the essential elements of healthcare and eliminating the wasteful activities, you will increase the productivity of your workforce and reduce costs.

A Study of Lean Healthcare Effectiveness

Follow this link for a study titled Lean Thinking In Healthcare: Review of Implementation Results.

If you’d like to read more, check out these Lean and Healthcare posts >>>

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Healthcare: Leadership from the Trenches

OpEx Learning Team — Fri, 28 Feb 2025 06:05:43 +0000

The healthcare industry has always struggled with change. Some have embraced quality improvement initiatives and philosophies with significant results. Many others still are missing the mark. They are implementing change management’ processes without embracing the true process. As a result, we are still experiencing healthcare quality and service that is far below what is expected in such a high risk industry.

Healthcare Leaders Must Embrace Change

One of the elements of great leadership is they have the ability to listen to and experience what goes on in the trenches, at the lowest levels of the organization. Healthcare leadership has a tendency to ignore their front line when exploring problems and listen to those workers who experience every aspect of their organization. These same leaders group around those connected to the C-suite and believe because of their education and experience, they are the only ones who possess the answers. Looking to people in an organization based upon position or education levels is still a disturbing trend in healthcare. The environment in a healthcare organization is still a class-based environment. Without extensive credibility at the end of their names on a signature block, the people with the most insight into the workings of the organization tend to be ignored. Even when the healthcare organization has embraced Lean Six Sigma practices, they restrict their focus of the programs based upon position or educational accomplishment.

Healthcare Demands a Change

The risk is too significant to ignore those who have significant amounts of institutional knowledge. The situation demands that if you really want to understand what is going on in your hospital, you need to get out from behind your desk or meeting room and start talking to those who are working the processes in the trenches. To do that, you need to be able to relate to those employees, establish trust, then be able to just listen! Only then, will you be able to find the diamonds in the rough. Otherwise, you are wasting valuable time and effort on improvement initiatives that, in the end, just won’t work.

Chasing Quality: EHR Exposed Opportunities with FMEA

OpEx Learning Team — Fri, 28 Feb 2025 06:04:53 +0000

Can Electronic Health Records (EHR) expose quality opportunities in our current Failure Mode and Effects Analysis (FMEA) mapping process? A recent study shows that EHR information can provide significant opportunities to improve FMEA mapping in the quality process. FMEA mapping simply outlines steps in any given process, then identifies and prioritizes the potential opportunities for failure. By using this systematic and prioritized method, teams can make consistent and continuous improvement. Conversely, when information is left unidentified in the FMEA, can real improvement be made?

Quality Opportunities Missed in FMEA

To understand this potential opportunity, researchers recently conducted a study where actual patient data was utilized and provided to a mock quality committee. As with any other FMEA, the committee put together their FMEA mapping based on the information provided to them. The research team then compared the information in the committee’s FMEA mapping the actual data identified in the EHR. The results were enlightening. The study showed that 35% of the processes completed were not identified in the committees FMEA mapping. More illuminating was the fact that people from 12 different categories or positions were involved in the discharge process, and not in the original FMEA mapping. Further, what the original FMEA mapping identified as one activity in their map, EHR data showed it was actually a multi-stepped process, involving completely different people.

EHR Strengthens FMEA Mapping

This study clearly shows the potential EHR has to strengthen and extend the reach of current FMEA mapping processes. Significant amounts of data previously undiscovered in EHR could have a dramatic effect on the success of FMEA mapping. Lean Six Sigma professionals should look to EHR as an untapped resource that could expose significant opportunities for success in your quality improvement opportunities. Use the EHR to drill down to any quality improvement opportunities that are truly hidden gems of quality.

Want help? You can access a FMEA template for FREE >>>

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Airing the Dirty Laundry in Healthcare: A Factory Tour

OpEx Learning Team — Fri, 28 Feb 2025 06:04:53 +0000

Healthcare runs on clean laundry! No matter what the scenario ¦ whether treating a patient in the ER, on a Med-Surg unit or in an outpatient clinic, the patient care cannot be delivered without clean linen. From washcloths, sheets, or blankets, to surgical scrubs or patient gowns, the healthcare environment runs on clean linen.

Wash, Dry and Fold

The United Hospital Services laundry is one of the 10 largest healthcare laundry plants in the United States. The plant processes over 36 million pounds of clean linen for healthcare facilities in the state of Indiana. The cleaning and processing of linen for healthcare is a combination of science and production. It is the science of how to clean and process various articles of linen to ensure they are germ free, sparkly clean in appearance, comfortable to the touch guaranteeing the maximum life of the item. The production is like the production of any other factory with linen being the product being manufactured. Almost every step in the manufacturing process is automated, with a few processes remaining a by hand’ operation. Employees are measured on the quality of their product, along with the quantity produced by the hour.

This Ain’t Your Mom’s Laundry

Commercial healthcare laundry operations are not your mom’s laundry! The science involved, along with the production manufacturing, require absolute focus on efficiency and quality. The industry is extremely competitive, and even 1/4 of a cent per pound cost could make the difference in a contract for the plant.

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Lean Optimization: The 5s Cure for the EHR

OpEx Learning Team — Fri, 28 Feb 2025 06:04:52 +0000

Can we find a cure for the EHR (electronic health record) through lean optimization and the 5S? The EHR is a digital version of a patient’s paper chart. It contains the medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory test results. The system can be challenging for most users. A survey conduct by the American Medical Association in 2015 indicated that 34% of respondents were either satisfied or very satisfied with their EHR. This is a significant drop from the same survey conducted in 2010 which showed 61% of respondents were satisfied or very satisfied.

Lean Optimization using the 5S

Unfortunately, there is a great deal of waste associated with a hospital’s EHR system. Clinicians have several complaints that demand some attention. First, there are just too many buttons cluttering the screen. Secondly, they feel that placing orders and documenting actions takes too long. Lastly, using the InBasket’ with secure communications is difficult and cumbersome.

This situation is perfect for the application of the 5S tool. The concept of using Sort, Set, Shine, Standardize and Sustain is ideal for this problem:

Sort – Removing unnecessary items, simplifying to keep value-add items only.
Set – Organize items in the right order to maximize efficiency and minimize wasted time.
Shine – Make the workspace clean and appealing to the eye.
Standardize – Implement best practices for all individuals, maintain standards, and consistency.
Sustain – Create and develop practices that are ongoing and encourage compliance.

Changing the Landscape

If you consider the millions of mouse clicks and hours spent in front of screens navigating the frustrations of EHR, lean optimization is in demand to bring relief to the users of the EHR system. Frankly, the system must change to ensure it achieves the goals that were established. In a recent survey from the American Journal of Emergency Medicine, a study found that ER physicians spent 44% of their time on duty entering data into the EHR. It goes without saying that most people would prefer to have our ER physicians and other clinicians spending a great deal more of their time with patient care, than struggling with the cumbersome nature of the EHR.

Want to learn more about 5S and visual “factory”?
Download the free training packet below!

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