It ain’t easy being Lean.
In fact, statistics show that more than 75 percent of all health care providers across the nation have tried various forms of Lean methodology and many are struggling with it. When asked about their experience, some of the common responses might be:
“While we experienced some initial success, we weren’t able to maintain it long term.”
“Unfortunately, we just don’t have the bandwidth for it right now.”
The shear complexity of our health care systems makes it hard to sustain our improvement gains. Although many struggle with it, there are success stories. For example, a major provider in the western U.S. saved nearly $190 million during its first six years of adopting a comprehensive Lean management system without cutting staff. The potential to achieve such results, along with the industry’s shift to a value-based reimbursement model, are why you need to take a second look at Lean methodology.
“Lean methodology requires a transformational shift comprised of a deep assessment, an effective design, adequate deployment and ongoing sustainment,” said David Munch, MD, senior principal at Vizient. “It is also critical to always keep the strategic vision front and center through ongoing employee communication during the transformation.”
The importance of keeping people engaged
The development of and respect for people is foundational to success. It is important to secure an ongoing commitment of time and resources from all levels of management – and particularly from executive leadership. Rather than just a handoff of responsibility from an executive team to a lower-level group, successful Lean operations require executives to be fully invested, requiring a fundamental change in how they lead.
“Executives are responsible for the support and development of those who report to them, and those who report to them are responsible for the support and development of those who report to them and so on, all the way to the front-line staff,” continued Munch. “At this point in time, there are many health care organizations that have demonstrated that Lean saves resources, improves care and improves morale. It’s not a matter of if it can be done, it’s a matter of ‘are we willing to put forth the effort to make it successful?’.”
The importance of executive buy-in was demonstrated by a health system in North Carolina that initially generated significant savings implementing Lean methodologies, but was unable to sustain it. Working with Vizient teams, they decided to “reset” and focus on their development in these methods and their commitment to the rest of the organization. That reset and leadership support enabled the health system to engineer a culture transformation around the Lean methodology that put them on the path toward sustained improvement. As their CEO stated, “Lean is not a project or new initiative, it is how we lead and do our work, day to day.”
Identifying opportunities through assessment
Assessing current processes is key when identifying non-value-added activities to eliminate waste in the existing way of doing things.
“It is extraordinary how many organizations think that having good data is all you need to improve. It’s an important component but insufficient in and of itself. There needs to be intentionality as to how you do the work. The how can be inefficient, ineffective and unreliable or it can be intentional, efficient, effective and reliable,” said Munch. “Also, every problem has a simple solution that may be wrong. That happens when you don’t know the problem you actually have. Effective process development in Lean methodology requires knowing what problems you have now so that you are informed as to what changes you need to make to improve.”
For new services where processes aren’t yet in place, a cross-functional team representing all key stakeholders should be formed. Team members are tasked with considering all possible ways and methods to design the best process to consistently deliver the quality outcomes. The success comes from the real-time exchange of ideas and dialogue that occurs among the team members.
Implementing new processes can also improve the patient care experience and create efficiencies that lead to additional revenue opportunities. A Tennessee hospital’s surgery center worked with Vizient to address its problem of excessive wait times for patients in pre-op holding with a process redesign that reduced average waiting periods per case by more than 30 minutes – and the improved efficiency allowed additional admissions, which increased revenue by $14 million annually.
“If the prospect of implementing and sustaining a successful Lean management system sounds like an ongoing evolution, it is. More accurately, it’s an iterative process of fact-based assessment, improvement and alignment among all stakeholders based on clear communication from top to bottom. As evidenced by the health system that saved nearly $190 million, that cost savings was generated by multiple iterations and streamlining of processes, coupled with sustained commitment from the entire organization,” added Munch.
Launching your Lean transformation
Vizient offers members advice on training, coaching and developing techniques that can be shared with your colleagues as you begin the transformation. You can also access case studies and thought leadership articles to see how other Vizient member organizations have undergone and navigated their own transformation. In addition, you can access the four-part Leading Lean series for a more comprehensive and detailed explanation of the transformation journey from launch to continued sustainment.