How to manage processes in a hospital and other medical facilities? So many variables affect realization of medical services that it is not a simple matter at all. Lean healthcare is about clinical porcesses optimization. Substantial services makes it imposible to be objectively evaluated. The most difficult aspect is its impremanence that isnpires to search for new solutions, tools and variations, in order to keep all services on the same good or better quality level. It isn’t so simple to describe a process and maintain these certain practices. Everyone aim for a kind of established standard, meaning the best current accessible technique and manner of performance abide by medical personnel. Universal solutions are result of everyday situations and aren’t good for client, namely the patient. Each physician, nurse or other member of medical personnel have their unique knowledge and experience which create different approaches to maintain into one process scheme. Simplicity of rules listed on a „paper” but in reality it may confront many aberrations and exceptions. Lean healthcare is geared towards both, efficient, lean services provision and useful tools and techniques to unify clinical process. Patients and personnel safety are number one priority.
Aims of lean healthcare
Lean healthcare philosphy includes set of precise tool and methods to optimize patient flow in clinical process, remove barriers and gaps causing errors and delays (losses and waste). Set of tools based on lean manufacturing is becoming more and more numerous. In order to improve any clinical process it is important to define its purpose, issues and obstacles faced by the personnel during every day work. Each hospital, its department or clinic differ a lot from each other by their infrastructure, use of disposable materials and reusable utilities, medical equipment and medications. While implementing lean healthcare philosphy it is crucial to consider the specificity of a department. Not alwayst the beneficial result from other department will work out for other clinic.
First practical use in Poland
Success of implementing lean hospitals is conditional to the target place but above all the people that work in it. Medical specialists, nurses, medical care assistants, technicians and all other parts of the personnel not only shall accomplish their tasks with all obligatory duties, present knowledge and internal procedures but also with an ability of operational communication. Soft skills play a significant role of medical personnel cooperation based on personnel-patient and personnel-personnel relations. Training does’t assure these essential skills so here is the point where professional practice and positive approach to a patient matters. Lean healthcare tools are to simplify communication, fill any gaps and enhance information accessibility. Best solution for above given problems may be 5S methodology, worksite organization, visual board and visual management. More about Polish hands-on implementation of this method is available at http://www.leanhospitals.pl/oferta/.
Tools of this kind are very useful on critical sites where an error may result with patients death or his severe complications e.g. integrated operating theatre. Proper infrastructure will optimize flow of medical equipment, utilities and the patient itself as a whole process. In order to achieve a legitimate optimization it is essential to map the process (use of VSM – visual stream mapping), identify every step of given process, define number of involved personnel, set intervals around all activities and define time consumption of each step. The result is a valid process map which will be helpful to design a future state map. One of lean tools called the spaghetti diagram can reduce distance made by personnel, its fatigue and increase availability towards patients. The results will present all most common paths used by personnel and later improvements may be implemented in accordance with the outcome paths. Another lean healthcare tool called Kaizen works as an application and suggestion system for personnel to submit any remarks, observations or inspirations to enhance any process. The first project implemented in Poland was about implementing visual management, medical and clinical process optimization and communication improvement of medical personnel at regional nephrology center (Polish RCN) in Szczecinek. Project had been awarded by worlds experts of lean management at Lean Enterprise Institute and has won the second prize as the best lean management implementation in Polish services sector. Katarzyna Złotowska as the head of the award-winning project leads several projects in hospitals accross Poland. The results are available on Lean Hospitals website containing knowledge base concentrated on lean healthcare and quality.
Lean healthcare benefits
In conclusion, lean healthcare in health services is one big innovation on a world scale and its results are measurable and surprisingly positive. Here are some advantages after implementing several tools and methods of lean hospitals in a medical entity:
- more than 60 000 zł lower costs of functioning process
- 90% less accidents
- 30% reduction of medical materials, drugs and equipment
- 20% better patients satisfaction and communication improvement
Each unit is composed of processes to be improved and uprate. Despite the fact that lean healthcare is a specific use of universal tools and solutions, the process-based approach and patient flow in a process are very convenient to use as well as easy to examine. Both are to create value added.