4 Lean Management Blunders to Avoid
Source: Becker’s Hospital Review – January 6, 2011
By: Molly Gamble
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Although many hospitals sing the praises of lean management, the trendy business philosophy still leaves room for error, particularly if implemented as a half-baked improvement project for certain areas of business. By keeping an eye on the following four problem areas, hospitals can continue to reap lean’s benefits and prevent it from becoming another flavor-of-the-month to hospital administrators, physicians and staff.
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Results plateau and hospital staff becomes disenfranchised. Anyone who has gone on a diet knows the frustration of plateaus — when rapid results suddenly give way to stagnancy and boredom. Such pauses may occur after hospitals tackle the low-hanging fruit of smaller, localized projects that take less time than larger initiatives. “A vast majority of hospitals rate themselves as a five or six (out of 10) on how well their implementation of the lean program is going,” says Ron Wince, president and CEO of Guidon Performance Solutions. Mr. Wince has worked with a number of healthcare organizations to identify hot spot lean problems. Since staff members help develop in lean strategies, the initiative often rallies unbridled enthusiasm that can quickly turn into cynicism when employees feel the honeymoon is over.
This is where hospital leaders need to not only become engaged in lean management, but become embedded in it — and not just in the early stage. “Sometimes leadership moves onto the next thing before lean even becomes a way of life in the hospital,” says Mr. Wince. “Because of that, it falls to the wayside and people grow frustrated.” Leadership needs to maintain enthusiasm and pressure on the hospital to continually find new opportunities to implement lean strategies. It’s also imperative for hospital leaders to engage all staff in the process — administrators, physicians, surgeons, etc. — and not allow the focus to shift solely on nurses or technicians. -
Not considering what lean can do for patient care. To get the most out of lean, hospitals should step away from a focus on financial gain and consider the patient perspective. In his experience, however, Mr. Wince says hospitals rarely examine lean from the patient vantage point. “When it comes to healthcare reform, a lot of the factors in the patient-centered view are also the things a hospital has to report on quality and outcomes,” says Mr. Wince. Through a successful lean program integrated with patient care, hospitals can report compliance by making parallels between care delivery and lean management.
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Using lean as an ala carte system. When hospitals pick and choose problems to be repaired by lean, that’s a problem in itself. “People sometimes pick the parts of the lean philosophy they like and don’t take it all,” says Mr. Wince. It’s nearly impossible to see the muscle without doing any heavy lifting, though, and hospitals should use the program to tackle issues other than simple waste reduction.
Once a hospital moves beyond localized function improvement — or hot spot projects — it should delve into its value streams or continuum of care. Look for weaknesses between a patient’s diagnosis to his or her last step in treatment. “We’ve done work on the continuum of care for Alzheimer’s patients, which was a span of four to five years,” says Mr. Wince. By moving to a year-to-year timeframe rather than a daily one, hospitals can see continuous results from implementing lean in long-term projects. -
Wearing blinders and not looking at handoffs upstream or downstream. A hospital might implement lean in its emergency department to increase throughout, but won’t apply strategies across the board or address its repercussions. Then, changes made in the emergency department are suddenly affecting the pharmacy, lab and countless other areas of the hospital. “People apply lean to one area of the hospital, but need to migrate upstream and downstream to understand its effects,” says Mr. Wince.
While people may be eager to apply lean in their own department or function, handoffs cannot fall to the backburner, especially since they often involve waste such as non-value added steps, flawed communication and rework loops. When lean is not uniformly carried out, employees are departments may point fingers at one another in a blame game, decreasing staff morale and lowering patient satisfaction. By meticulously planning changes in a hospital-wide process map, hospitals can make lean strategies parallel and avoid interdepartmental disasters.
All contents © 2011 Becker’s Hospital Review. All Rights Reserved.
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