Lean Health Care
Is the concept of Lean Manufacturing is equally applicable in Health care as it is in manufacturing industry?
Lean manufacturing concept was originated from Toyota Production System (TPS). This was designed for continuous process improvement in automobile industry. Then this concept was so much popularized that, it is now being used in service industry like Hotels, Restaurants, Telecom and Health Care etc.
Concept of TPS was introduced by Taiichi Ohno, and he focused on improvement of manufacturing and support processes by involvement of associated persons. Taiichi focused on personnel training, human creativity and standardization.
Concept of Lean Manufacturing is equally applicable in Health care as it is in manufacturing industry. In hospitals, different processes are being carried out like, operations, medical tests, Patient admissions, emergency department care, regular 7 routine checkups etc. In health care, internal customers are Doctors, Nurses, Administration and external customers are patients. But customer concept of quality in health care is totally different from product’s buyer concept.
In health care, there are different types of wastes associated. Commonly found waste are:
Inventory is major contributing factor in hospital related costs. Sometimes, more items are procured then required, so it is considered as dead inventory. But lean manufacturing focus on fewer inventories but with frequent shipments. This will save money and place for more productive use.
Transportation waste is another key factor that lean manufacturing addresses. In Health care, if facilities are not properly designed then patients, test results, doctors, nurses and other stakeholders will have to walk and more time will be wasted.
Defects in health care are intolerable, because they can cause ir-reversible damage to human health. Common defects or errors can be wrong operations, wrong tests, and wrong test reports. In lean manufacturing, concept of Mistake Proofing (Poka Yoka) is used to avoid such defects.
Waiting Time waste is main factor in customer dis-satisfaction. Customer waiting time can be following:
- Waiting time for operation
- Waiting time for emergency treatment
- Waiting time for test results
- Waiting time for test sample
- Waiting time for routine check up
To become a lean health care organization, companies need to train their employees in different tools of lean. Some of the tools that can be very helpful are:
- Total productive maintenance
- Just in time
- Cellular flow & Layout
- Pull Push system
- Kanban
- Change management Teams and teamwork
- Standardized work instructions
- 5S Visual Work place
- Point of use storage
- Batch size reduction
- Quick changeover (SMED)
- Poka-yoke
- Quality Function Deployment (QFD)
- Jidoka
- Self-Directed Work Teams
- Autonomation
- Value stream mapping
All the above mentioned tools have significant effect on process improvement in health care systems and also it is evident that defects are highly not desirable. So, in order to become a defect free organization, one must start applying lean principles and tool in their organization. On more important thing is that, whatever tool you select, try yourself to apply and start your work from very simple tools (like 5S, Kaizen) as it will enhance motivation level of employees.
Oskar Olofsson, 2009
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