Not Sleepless in Seattle

DPA Insights

How One Medical Center Embraces Lean

By Tony Rodriguez, President, Daniel Penn Associates, LLC

In June, we talked about Escape Fire, an in-your-face documentary about how we need to find a better way to provide effective care more efficiently. Reinforcing the need for change, the latest Institute of Medicine data shows that $750B is wasted each year in the U.S. in unnecessary medical expenses.

To stem the financial hemorrhaging and hold their own in a competitive market, many hospitals have begun adapting what works in efficient manufacturing environments to their unique goals and requirements.

Not Sleepless in Seattle

One medical center is way ahead of the curve. Recently PBS showed how Virginia Mason Medical Center in Seattle is rooting out waste by using principals of the Toyota Lean Manufacturing System.

More than a decade ago, Virginia Mason CEO Gary Kaplan, M.D., decided he couldn’t wait for change. He went to Japan and studied how Toyota’s renowned model reduced waste (of waiting, movement, over-processing, excessive inventory) and began applying these principals to different practice areas within the hospital.

The hospital is now using special software to determine if expensive tests are really necessary based on a detailed list of criteria. MA’s, or flow managers, help administrators, nurses and doctors become more efficient at scheduling and planning appointments. As one of the hospital’s doctors put it, “We’re no longer the center of the universe. The patients are, and a team is delivering the care.”

It wasn’t an easy transition. But by re-thinking old methods and slowly bringing all employees on board, the effort is paying off. By eliminating large storage rooms and replacing them with smaller just-in-time Kanban system storage areas, nurses spend less time finding and tracking paperwork and more time with patients. Patients are scheduled for appointments as they arrive, preventing end-of-the-day bottlenecks. Doctors and nurses work together more seamlessly. Similar to how Toyota empowers every employee to halt the production line if they perceive a problem, every hospital employee at Virginia Mason Medical Center is expected to report potential problems with patients’ care.

The results?

Reduced liability costs. Reduced delivery-of-care costs. Better patient care. Better patient outcomes.

Better patient satisfaction.

Lean demands both culture change and a continuous improvement mindset. Virginia Mason Medical Center has been at this since 2002. As a result, they were named a Best Hospital of the Decade by The Leapfrog Group. Similarly, for your hospital to succeed at Lean, a long-term commitment of time and resources from top management, clinicians and support staff is essential.

Where are you on this journey? Which of these seven factors driving health care costs do you need to better manage? How are you engaging clinicians and support staff to create more efficient ways of caring for patients that improve quality and outcomes? What challenges and success stories can you share? Leave your comments below.

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