FIT for Healthcare: Fundamentally Improved Techniques

Lean from the healthcare perspective:

Having been called upon on numerous occasions to lead organizational development and process improvement consulting and training projects in the healthcare industry, we now have a clear understanding of improvement opportunities in this sector. Interestingly, the lean techniques we use in manufacturing are highly beneficial in healthcare as well. The same approach in eliminating waste and non-value adding activities in the value stream, as well as defining quality and value from the customers point of view are producing outstanding results. These projects are not without problems however.

What few, in the field of lean, understand is that lean techniques are not a 'one size fits all' approach. We must cater each project to fit the needs of the client. As most agree, we can not cherry-pick individual lean initiatives. You either go lean or you don't. However, we must cater each project to fit the needs of the client. In the healthcare industry this is even more apparent. Diving in to a project in the healthcare industry with a purely "lean" approach can, and often does, result in unbendable resistance. Much of the reason for this is the misconception that lean processes take the focus away from the 'people' involved when in fact employees and customers are even more involved following a lean implementation. This misconception can be problematic.

For example, I recently lead a group of nurses and supply management personnel through a kaizen event. The trainees were divided into two teams. One team was focused on improving the facility's overall supply management process. The second team was concerned with patient flow through their respective department. As with all of our projects, we guided the teams through the process of assessing the current situation and identifying the true problems. As a result, we found that a kanban system for supply management would be most beneficial and the second team would see the greatest immediate improvements through 5S. Of course, these were simply starting points. A lean transformation is much more involved. However, after determining these starting points our team explained the two concepts, kanban and 5S. If ever there were a need for a fireproof suit that training session could have easily convinced tailors worldwide to file for a patent. If it had not been for our ability to maintain composure and keep teams moving in a positive direction we could have easily lost our audience.

From this point, we simply coached the teams through the process of putting together an action plan and avoided the lean terminology. Upon completion, the teams had in fact implemented a kanban system and the 5S project was moving along nicely. Allowing the teams to take ownership in this project produced outstanding results. When all was said and done I explained to the teams that they had, after great resistance, done a wonderful job of implementing both 5S and a kanban system. The teams were very proud of their work, but were humbled a bit after realizing they had implemented what they had initially fiercely resisted.

This is but one example. Lean techniques, although highly beneficial in the healthcare industry, are resisted more so than in manufacturing. Occasionally, those in healthcare are so adamant in their beliefs and values that they refuse to even consider "lean" as a viable solution.

Therefore, we have been at the drawing board for months designing a program that utilizes lean methodology but seems more fitting in healthcare. We have coined the approach FIT, Fundamentally Improved Techniques. As mentioned, lean enterprise requires increased involvement of employees and customers. However, our FIT program begins with an even more people-oriented approach. Our FIT program begins and ends with the quality of patient care. This is the priority. Once this is established associates at all levels of the organization are more open and receptive to lean concepts.

The results include an improved healthcare experience, lower cost, increased profits, and more rewarding work. If interested in more information we will gladly visit your facility to provide a free FIT info session. Please contact us for more info.

Brian Leonard M.S. 2006