Lean in Healthcare

Rick Bohan

I found an article about lean in healthcare over at Mark Graban’s Lean Blog thealth-care-leanhat describes a horrific set of circumstances an acquaintance of his and the acquaintance’s wife experienced at the Emergency Room of a nearby hospital.  You should read the entire article (How Can a Story Like This Occur?) but here are a few excerpts that will give you a good idea as to what happened:

“No triage at the front desk. She had a potentially life-threatening condition from the risk of hemorrhage, but a guy with a sore knee and a kid with a cold were taken before my wife.

“No pain management for over three hours, even after she lost consciousness several times. Nurse said they had recently implemented a new EMR system and things just took longer because they weren’t trained properly.

“When she vomited from the pain, I had to clean her up and help her with the gown while the nurse watched.

“No radiology technician to perform the ultrasound needed for the diagnosis. We had to wait until one was called in from home.

And that’s just a sample.

Here’s the kicker:  the acquaintance chose that ER because the hospital advertised itself as having a “15 minute ER wait pledge” and was implementing lean methods.

Those of us who have been helping organizations implement lean principles and methods can pretty much make a list as to what’s going on here (or not going on).  It’s far easier to tell people that you’re implementing lean (or worse, that you “are lean already”) than it is to, you know, actually implement it.  It’s far easier to do a bit of lean training than it is to actually require folks to apply that training.  It’s far easier to utilize a few tools from the lean box here and there than it is to actually engage in the full transformation of the organization’s culture, systems and processes, and resources.

The sad part is that people both outside and inside the organization don’t always know all of this.  When they hear that the organization is implementing lean and continuous improvement but experience bad outcomes themselves, they sometimes blame the improvement initiative itself rather than the dumb managers in charge of it.  And that’s a shame.


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