Have you heard of Lean Healthcare? I am sure many of you have and that quite a few havent. The concept of lean healthcare has been adopted from manufacturers. The idea of lean manufacturing and lean service are most visibly displayed by Toyota Motor Corporation. Toyota has so refined and developed the techniques that organizations around the world are using their ideas to improve their own organization and are benchmarking against Toyota.

Lean healthcare is basically reducing waste in the delivery of service both directly to the patient and to internal customers, such as human resource services to employees. For instance, lean techniques help eliminate duplicated procedures, such as a nurse taking the blood pressure of a patient and then the doctor doing the same a few minutes later. It also makes sure that all of the necessary tools and products are in an examination room when needed. It is beyond the scope of this article to fully describe lean healthcare; many books have been written about it. In fact, the American Society of Quality in their online bookstore has several titles, including Lean-Six Sigma for Healthcare. I would like to define a few techniques found in lean healthcare to illustrate its value, though.

One of the most commonly used tools is Value Stream Mapping. VSM displays in a physical graph the process from beginning to end of the delivery of a service or procedure in order to identify wasted effort or steps that dont add value to the results. For instance, in the April 2005 issue of Quality Progress the article Lean Six Sigma Reduces Medication Errors presents the process by which a team of nurses and pharmacists in a hospital setting reduced the waiting time and errors in the delivery of medication from the pharmacy to the patient. By the use of VSM and other statistical techniques, the error rate was reduced from 0.33% to 0.14% in 5 months and a savings of $550,000 was realized.

Lean healthcare emphasizes tapping employees knowledge to improve processes. Leaders of an organization empower employees to present ideas for improvement and then enact promising ones in order to save time, money and improve patient health and satisfaction. One such technique for empowering employees is the kaizen. This is a meeting of staff to quickly generate solutions to a process which has been identified as needing improvement; the team members are representatives of those actually involved in the process. A kaizen event is marked as a brief, intense effort to solve such a problem. It may take several hours or a day or two. The work time lost of the members of the kaizen is more than offset by the outcomes of the meeting.

Lean healthcare is driven by the identified needs of the patient or customer. For instance, waiting time is deemed waste. A patient having to wait more than a day or two to see a doctor for an office appointment is waste. Many in healthcare think that this is a problem which is almost impossible to solve. It isnt. Solutions to this problem have been described in several articles of Family Practice Management, a publication of the American Academy of Family Physicians. The ideas are easily adopted to sites which arent primary care physician practices.

Lean identifies the best techniques and strategies to deliver quality care and then makes them standard operating procedure. In fact, it is a good idea to write a manual of the best processes in order that any employee can reference at any time and also in order to use it as a training tool for new employees.

I would like to urge you to look deeper into the ideas of lean healthcare. There are many publications describing it, as the ASQ publication mentioned earlier. The April 2006 issue of Family Practice Management has a great article for lean in the doctors office; it can be found for free online. Your efforts in implementing lean techniques will be rewarding to both you and your patients.