A Guide To Lean Healthcare Workflows
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A Guide to Lean Healthcare Workflows
Is Lean a fit for your healthcare organization? Various methodologies can be used to help organizations achieve their objectives depending on their criteria: lowest risk of failure, fast to resolution, or lowest cost for deployment. But what every organization should consider is which methodology will have the greatest impact. Lean, a systematic approach to understanding and optimizing processes, may be the fit for your organization. Learn more in this new IBM® RedpaperTM publication, A Guide to Lean Healthcare Workflows, by Jerry Green and Amy Valentini of Phytel (An IBM Company). The paper delves into the five steps of Lean: Define value from the patient's perspective Map the value stream, and identify issues and constraints Remove waste, and make the value flow without interruption Implement the solution, and allow patients to pull value Maintain the gain, and pursue perfection It describes each step in-depth and includes techniques, example worksheets, and materials that can be used during the overall analysis and implementation process. And it provides insights that are derived from the real-world experience of the authors. This paper is intended to serve as a guide for readers during a process-improvement project and is not necessarily intended to be read end-to-end in one sitting. It is written primarily for clinical practitioners to use as a step-by-step guide to lean out clinical workflows without having to rely on complex statistical hypothesis-testing tools. This guide can also be used by clinical or nonclinical practitioners in non-patient-centered workflows. The steps are based on a universal Lean language that uses industry-standard terms and techniques and, therefore, can be applied to almost any process.
The Lean Healthcare Handbook
The book shows readers exactly how to use Lean tools to design healthcare work that is smooth, efficient, error free and focused on patients and patient outcomes. It includes in-depth discussions of every important Lean tool, including value stream maps, takt time, spaghetti diagrams, workcell design, 5S, SMED, A3, Kanban, Kaizen and many more, all presented in the context of healthcare. For example, the book explains the importance of quick operating room or exam room changeovers and shows the reader specific methods for drastically reducing changeover time. Readers will learn to create healthcare value streams where workflows are based on the pull of customer/patient demand. The book also presents a variety of ways to continue improving after initial Lean successes. Methods for finding the root causes of problems and implementing effective solutions are described and demonstrated. The approach taught here is based on the Toyota Production System, which has been adopted worldwide by healthcare organizations for use in clinical, non-clinical and administrative areas.
Lean Healthcare Systems Engineering for Clinical Environments
It has been almost 20 years since the Institute of Medicine released the seminal report titled, Crossing the Quality Chasm. In it, the IoM identified six domains of care quality (safe, timely, effective, efficient, equitable, and patient-centric) and noted a huge gap between the current state and the desired state. Although this report received a great deal of attention, sadly there has been little progress in these areas. In the U.S., healthcare still has huge disparities, is inefficient, and is fragmented with delays in care that are often unsafe. Most U.S. citizens are expected to suffer from a diagnostic error sometime during their lifetime, not receive a large fraction of recommended care, and pay for one of the most expensive systems in the world. Much has been written about quality improvement over the years but many prominent quality and safety experts. Yet progress has been slow. Some have called on the healthcare professions to look outside of healthcare to other industries using examples in nuclear power and airlines for safety, the hotel and entertainment industry for a ‘customer’ focus, and the automotive industry, particularly Toyota for efficiency (Lean). This book by Dr. Oppenheim on lean healthcare systems engineering (LHSE) is a fresh approach that brings forth concepts that systems engineers have used in huge national defense projects. What’s unique in this book is that these powerful system engineering tools are modified to be able to address smaller sized healthcare problems that still involve similar problems in fragmentation and poor communication and coordination. This book is an invaluable reference for a new powerful process named Lean Healthcare Systems Engineering (LHSE) for managing workflow and care improvement projects in all clinical environments. The book applies to ambulatory clinics and hospitals of all types including operating rooms, emergency departments, and ancillary departments, clinical and imaging laboratories, pharmacies, and population health. The book presents a generic rigorous but not mathematical step-by-step process of integrated healthcare, systems engineering and Lean. The book also contains the first major product created with the LHSE process, namely tabularized summaries of representative projects in healthcare delivery applications, called Lean Enablers for Healthcare Projects. Each full-page enabler table lists the challenges and wastes, powerful improvement goals, risks, and expected benefits, and some useful descriptions of the healthcare system of interest. The book provides user-friendly solutions to major problems in healthcare delivery operations in all clinical environments, addressing fragmentation, wastes, wrong incentives, ad-hoc and stove-piped management, lack of optimized processes, hierarchy gradient, lack of systems thinking, “blaming and shaming culture”, burnout of providers and many others.