Healthcare providers are typically driven to continually improve. Frontline workers deal daily with the consequences of inefficiencies and waste in the system. Personally, my family members in Healthcare are always talking about "if we just did it this way then everything would run a lot better." Why not let them make those improvements? Some institutions do. One process that does this is a methodology developed in automobile manufacturing called Lean. We have mentioned Lean before, but let's talk about the concepts and applications to Healthcare.

The intent of Lean is to create a high-quality product or service while minimizing waste. Under Lean, any process that does not contribute to the value of the product must be reduced or eliminated. There are probably a few inefficiencies you could think of right away that are non-essential to patient care.

Note this is not, as some fear, the slash and burn - bring in consultants to fire everybody - approach like in the movie Office Space.

Instead, organizational improvement feeds off of individual improvement. The Lean approach values the elimination of overburden and unevenness in the workforce. The approach empowers frontline employees to expose inefficiencies and experiment with ways to smooth the workflow. This benefits the institution with an increased ability to respond and adapt to industry changes versus using top-down methods.

"Sounds great, but we are not building cars here."

There are some notable successes of Lean in Healthcare. Virginia Mason Hospital adopted Lean in 2002 after a challenge from their board to focus on improving patient care. They had marked improvements after redesigning their processes. One powerful result they achieved was the reduction of cumulative nurse walking distance in the hospital by 750 miles per day. Their success led them to create the Virginia Mason Institute to help other Healthcare systems successfully adopt Lean methods.

Many organizations that try Lean do not continue the effort in the long-term. Process improvement through Lean requires a long-term commitment and a buy-in from all employees. Reorganizing procedures can be difficult across an institution and the initial investment in resources can be prohibitive.

"But it sounds like a good idea, how can we make it work???"

Patience is the key. A clear vision and values must be developed and consistently communicated by leadership. Benchmarks must be set and KPI's established to measure progress over time. Frontline staff needs to be fully supported by leadership through the whole process and empowered to define areas that can be improved. New ideas must be allowed time to be fully refined. If an experiment isn't achieving the desired results, look at feedback, make adjustments and try another iteration.

There are variations of Lean methodology, but continued improvement through employee input and empowerment is the common value. Thoughtful adaptation is beneficial in the field of Healthcare which is always evolving through new knowledge, procedures, regulation, and technology.