For most healthcare organizations, developing a strategic plan is much easier than executing it. The industry’s complex and evolving regulations and payment systems, changing practice and delivery models, clinical variation, and rising patient acuity force providers into a state of constant reactivity. Under these conditions, carrying out a strategic vision seems improbable, if not impossible.
Lean management strategies can help leadership escape this cycle of reactivity by empowering employees to implement sustainable, prioritized change.
HOW IT WORKS
By aligning employees’ work and daily improvement efforts with the strategic direction of an organization, lean management systems help achieve key business objectives faster.
The principles and practices of lean management are derived from the factory oriented Toyota Management System, which emphasizes improving processes and developing people. These concepts are applicable to any industry and are ideal for health care.
A SOLUTION TO THE EXECUTION DILEMMA
Leadership’s ability to execute and sustain change is impeded by taking on too many organizational initiatives and objectives at once with limited focus and resources. This creates what’s known as the execution dilemma.
Lean management can help leadership resolve the execution dilemma by focusing an organization on a few vital priorities, then helping employees establish and understand the connection between the work they’re doing on a daily basis and those strategic goals. This requires leadership to empower and train everyone within their organization to be effective problem solvers, focusing their efforts on solving the problems that matter most.
Solving execution problems with lean management has wide-ranging potential benefits for employees as well as patients.
The application of lean management in healthcare is still relatively new and has only occurred over the last two decades. Still, organizations that have successfully implemented this management system see significant improvement in a number of areas. Specifically, they’ve realized as high as 50% average improvement in patient access, cost reduction, patient throughput, waits and delays, defect reduction, safety and clinical outcomes.
EMPLOYEES AND PHYSICIANS
Staff and physician engagement as well as satisfaction also increases as team members find purpose in their work and gain a deeper understanding of the value they provide. Lean organizations have dramatically improved employee retention, almost eliminated unwanted turnover and the associated costs, and helped reduce physician burnout.
The following are examples of successful lean health care system implementations.
Between 2012 and 2014, a hospital in Northern California applied lean management strategies and showed strong improvement in a number of areas.
• 50% improvement in inpatient length of stay, which dropped by an average of 1.75 days
• 11% drop in readmission rates
• 50% growth in transfer volume
• 50% reduction in hospital-acquired pressure ulcers
• 30–50% improvement in turnaround times for ancillary services
Another hospital in Central California also experienced promising results after implementing lean practices in its trauma center and emergency department between 2015 and 2017.
• Left-without-being-seen rates dropped from 15% to less than 1%
• Reduction in door-to-provider time, which dropped from over 45 minutes to under nine
• 35% improvement in employee retention
• 1:4 return on investment in lean practices
• $600,000 annual reduction in surgical center expenses
A shift to the lean management paradigm in health care makes it possible to improve key areas, such as quality and safety as well as customer and staff satisfaction—without adding resources and while reducing costs. To get started, contact your Moss Adams professional.
Jonathan Felton, MHA, Director, Health Care Consulting, is a member of Rona Consulting Group, the lean consulting practice of Moss Adams. He’s a lean-certified health care executive with a consistent focus on leadership and cultural development. He understands the challenges of leading transformation in large, complex health care environments and possesses significant experience in hospital and health care operations, physician services and program development, and strategic planning and deployment. He can be reached at firstname.lastname@example.org or (206) 302-6894
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