Lean Health Care

Aug 13 2013

Par Versus Kanban: Managing Variable Usage | Lean Hospital Group

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The great majority of hospitals in the United States manage hospital supplies using what is called the Par Level method. One of the strengths of this method, it is claimed, is that it works well in the face of variable usage.

 

 

Michel Baudin‘s insight:

If you have always wanted to know how hospitals managed their inventory of medicines, the article will both tell you the traditional method they have been using, and how the Kanban system can outperform it.

See on www.leanhospitalgroup.com

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Mar 25 2013

The Virginia Mason Production System | Hospital Impact

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“Virginia Mason Medical Center in Seattle was the first in the nation to adapt the Toyota Production System as the framework for managing a medical center. We call our version the Virginia Mason Production System (VMPS). It is our management method to identify and eliminate waste and inefficiency in the numerous processes that are part of the healthcare experience.

By streamlining repetitive and low-touch aspects of care delivery, our physicians, nurses and other clinical staff members are freed to spend more time talking with, listening to and treating patients. We are discovering it is possible to provide high-quality care with lower resource utilization.”

Michel Baudin‘s insight:

This blog post by the CEO of Virginia Mason sheds some light on the specifics of the “Virginia Mason Production System.” He confirms that the focus has been on administrative tasks to allow doctors and nurses to spend more time with patients, rather than on what happens while the doctor or the nurse is with the patient.

What he describes involves breaking down communications and administrative transactions in “small lots,” organizing groups of contiguous rooms into “cells,” and reassigning tasks to better leverage available skills.

See on www.hospitalimpact.org

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Mar 17 2013

Visitors see ‘lean’ during RUH tour | Star Phoenix

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 Technology is often touted as the cure for many of our modern afflictions.Funny, then, that a whiteboard in the staff room could make such a difference in how the city’s busiest emergency department runs.”It’s very low-tech,” says Jon Schmid, the registered nurse manager for Royal UniversityHospital’s emergency department. “But the impact it has on our organization is huge.”…

Michel Baudin‘s insight:

The text of the article is informative, particularly about the use of a white board, but the picture does not show this white board. In fact, it seems unrelated to the article, as if the newspaper just slapped on a stock photo from a hospital.

As it is, however, this photo is a good reason for the quotes around the word “Lean.” It is an encyclopedia of work space design mistakes, with work surfaces at uneven and ergonomically inappropriate heights, causing people to stoop, or even squat to access the refrigerator. Not to mention empty space in the center and chairs.

Workspace design mistakes

See on www.thestarphoenix.com

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Mar 1 2013

Lean in administration at St. Luke’s Internal Medicine | David C. Pate

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TEAMwork is St. Luke’s application of lean principles. It’s our management operating system. TEAMwork stands for timely, effective, accountable, measureable work. And it’s making its way through St. Luke’s Health System as we gain on our Triple Aim of better health, better care, and lower costs.

Starting last summer, SLIM embarked on a top-to-bottom examination of how it conducted its work. They wanted to eliminate waste by tapping into the potential and knowledge of every member of the clinic team and build a culture of continuous improvement.

 

 

Michel Baudin‘s insight:

The improvements described are all about supplies and the handling of patients by nurses and administrative staff.

There is not a word about any changes to the work of doctors themselves or involvement by doctors in the improvement process. What form might that take? I don’t know, but, the last industrial engineers to work on health care before Lean were Frank and Lillian Gilbreth 100 years ago, and their focus was the work of surgeons inside operating rooms, not patient handling before and after they see a doctor.

The result of their work was the now standard mode of operation in which the surgeon calls for tools that are handed to him by nurses. It seems hard to believe today but, earlier, surgeons would actually leave patients to fetch tools.

Following in the Gilbreths’ footsteps today would mean for Lean Health Care to get involved with the core of the activity: what doctors do with patients.

In manufacturing, successful Lean implementations start with the work of production on the shop floor, not with the logistics upstream and downstream from production. First you worry about line layout, work station design, and the jobs of production operators. Then you move on to keeping them supplied and shipping their output.

See on drpate.stlukesblogs.org

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