Value 'key for hospitals using lean'

Many hospitals around the world are now using lean processing in a bid to improve efficiency in the workplace and it is clear the management tactic is only going to grow in popularity.

Dr Terry Platchek, a clinical instructor at Lucile Packard Children's Hospital at Stanford University and co-author of Lean Healthcare for the Hospitalist, which is an academic paper on lean care delivery, stated value is a crucial compartment of implementing lean ideas in a hospital setting.

Speaking to Becker's Hospital Review, he explained this is due to the fact that it needs to be clearly discerned, adding: "In healthcare, value is something that changes the form, fit or function of a treatment or process. It will help alleviate pain or remove suffering."

Packard is one of the firms to have embraced lean processing in a big way over the course of recent years, following in the footsteps of Japanese carmaker Toyota, which was the first massive organisation to take on lean principles and apply them across the company.

Dr Platchek has been heavily involved in the implementation of lean processing at Packard and he explained how the method can benefit those working in the healthcare sector.

It was noted by the expert that the meaning of lean in a hospital setting involves considering the definition of value from the perspective of the patient rather than the managerial team and then putting in place efficient clinical changes in order to ensure valuable care is provided.

He pointed out that this means there is a need for a shift in mindset to be brought in from the top of the hospital to the bottom, moving from seeing clinical care as a series of tasks that need to be completed as quickly as possible, to a process in which there can be continuous improvements in a bid to achieve the goal of valuable outcomes for patients.

However, Dr Platchek stressed that this does not necessarily mean longer hours for those who are working in a hospital, as the goal is to achieve "valuable outcomes with the least amount of work possible".

One of the changes made at Packard as a result of the implementation of lean ideas in hospitals was to amend the time physicians enter in their orders to immediately following a patient visit, as they traditionally make rounds and place an order at the end of their shift, which is far from efficient from the point of view of the patient, who is left to wait around for what can be hours in some cases.

Dr Platchek explained some drastic improvements have been made by Packard as a result of this simple change, which is one that may now be copied at organisations across the world.

Another of the ways Packard has been able to increase efficiency in hospitals has been by cutting out waste from the care delivery model, which can be achieved through removing any processes that are shown by analysis to be weighing them down.

Dr Platchek explained that by implementing a lean care model and identifying and correcting wasteful processes, the hospital found that it was able to reduce wait times for operating rooms from two hours to 60 minutes in a span of two weeks by taking measures such as eliminating its pre-operation holding area for ambulatory patients.

"You can cut out 50 per cent of the waste in about a week. It takes a lot of effort, involvement of the front line worker and some upfront cost, but we can improve these processes," he said, a comment that could encourage hospitals to check out the immediate benefits that the implementation of lean processing can have on levels of efficiency.

The specialist also stressed the importance of ensuring lean methods are being used from each member of staff at a hospital, as it will not work if it is only physicians who are taking on board the changes that need to be made in order to reduce waste.

Staff members such as cleaners ought to be involved in the process, as they may be able to highlight areas where there is waste that can be cut away by making processes more efficient.

"Every healthcare worker needs to be a problem solver," he said, highlighting the fact lean management techniques are an ongoing process, rather than being introduced and then done away with after a period of time.

Understanding the root of inefficiency or patient dissatisfaction was named by Dr Platchek as the key to implementing lean ideas successfully in a hospital setting and it is by doing this that facilities will be able to achieve the very best results.

Packard specialises in the care of babies, children, adolescents and expectant mothers and is one of the most famous hospitals in the US, boasting close to 5,000 support staff and more than 650 doctors.

Many of the physicians who work at the facility also serve as professors at the Stanford University School of Medicine, which is located on the same site.