The Opportunities for Lean Thinking in Healthcare
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By Daniel T Jones of Lean Enterprise Academy shown at the 1st Lean Healthcare Forum 2006 on 25th June 2006 ran by the Lean Enterprise Academy
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The Opportunities for Lean Thinking in Healthcare
- 1. Lean Healthcare Forum 2006 1
- 2. 2 Lean Enterprise Academy www.leanuk.org The Opportunities for Lean Thinking in Healthcare Daniel T Jones Chairman Lean Enterprise Academy
- 3. 3 Lean Enterprise Academy www.leanuk.org Welcome • To the first Forum of the Lean Healthcare Network • An independent network to help accelerate the implementation of lean across the NHS • Building on the work of the pioneers of lean healthcare in the NHS and across the globe • And the Lean Enterprise Academy’s experience in spreading lean across many industries • Supported and advised by today’s speakers and :- • NHS Institute for Innovation and Improvement • NHS Confederation • NHS Health and Social Care Information Centre
- 4. 4 Lean Enterprise Academy www.leanuk.org Today • Who are we? • Hospital Trusts 91 • Primary and Mental Health Care Trusts 20 • Ambulance Service 12 • Strategic Health Authorities 38 • Other NHS Institutions 30 • Consultants, Service Providers etc. 46 • Today’s tasks:- • Develop a common understanding of the lean opportunities in the NHS • Lean more about implementing lean and creating flow • Collect views and share plans for future action
- 5. 5 Lean Enterprise Academy www.leanuk.org Lean Thinking • Lean Thinking derives from observing best practice organisations, not from theory • It has a long history – Toyota the leading example • Their example shows us the power of a relentless focus on creating brilliant processes • From them we extracted the principles for designing lean processes • And how to manage them through a scientific approach to problem solving close to the source • It is a path that will separate the sheep from the goats – it not a magic recipe or a quick fix!
- 6. 6 Lean Enterprise Academy www.leanuk.org Process Thinking • We traditionally see an organisation as a collection of departments or activities, managed separately and with time buffers between them • Performance is improved by setting targets, by switching managers and by restructuring • Lean thinkers see an organisation as a collection of customer, provider and support processes • The task is to identify the value in each process, to see and manage the end-to-end flows and to synchronise the support flows • But what are the real flows in healthcare?
- 7. 7 Lean Enterprise Academy www.leanuk.org Seeing Value • Each customer, provider and support process contains many steps: - • Which steps create value – solve the problem? • Which steps simply waste people’s time? • What is the experience like for each party? • Do queues really help? • Do they change the amount of work to be done or smooth demand? • Do they improve the utilisation of our most expensive assets? • Can we distinguish between actual and created demand?
- 8. 8 Lean Enterprise Academy www.leanuk.org Value Streams • Mapping the combined customer and provider process reveals lots of waste and dysfunctions • Steps that are not performed in the same way each time – with no standard and no review • We can do a lot to remove ambiguities from how tasks are performed and find fail safe procedures • We can also track root causes and redesign steps to eliminate errors • All this helps to improve quality • But to find the stability to enable us to link steps together to create flow we need to analyse the different types of work to be done
- 9. 9 Lean Enterprise Academy www.leanuk.org Finding Stability • The flow of work through healthcare is complicated – yet much of the work is routine • If we can identify this routine work and manage it separately we can begin the virtuous lean circle • We can standardise the steps, synchronise them so the work flows through each step without interruption and flow in line with real demand • We also discover as we do this we eliminate lots of scheduling and queues, we can plan ahead better and better utilise our assets • And we free up time for experts to concentrate on solving the really complicated and rare work!
- 10. 10 Lean Enterprise Academy www.leanuk.org Making the Change • None of this happens unless someone is responsible for rethinking the whole process • Supported by all those involved in running the process • Who together, with expert help, develop a future state plan • Which shows where to conduct breakthrough improvement events and where to use lean tools • This is actually an experiential and shared learning process – that goes on for ever! • The only changes that last are the ones you do!
- 11. 11 Lean Enterprise Academy www.leanuk.org In Summary • Lean Thinking embeds quality at source into every process – with big implications for mortality and medical errors • It also frees up the latent capacity in current systems – without requiring new capital • It releases more time to spend on solving the difficult cases – while going home on time! • As you improve current processes you see new opportunities for designing alternative ways of delivering care – with quite different working practices and right sized equipment • There is no one lean best way – but several!
- 12. 12 Lean Enterprise Academy www.leanuk.org The Opportunities for Lean Thinking in Healthcare Daniel T Jones Chairman Lean Enterprise Academy
- 13. Lean Healthcare Forum 2006 13