Lean In Healthcare

In healthcare, throughput refers to the ED process that impacts patient flow (Jarousse 2011). Process and flow began to be scrutinized for opportunities to improve the overcrowding by becoming more efficient. Due to this new process focus, throughput was born. This is also the point where lean flow or lean thinking became prevalent into healthcare from a manufacturing stand point to improve throughput. Lean principles revolve around removing non value added steps and standardizing work flow and processes. When applied aggressively hospital wide, lean principles can have a dramatic effect on productivity, cost, and quality. Numerous books concerning lean healthcare have been published in recent years (Crane & Noon 2011).

Lean manufacturing is the production of goods using less of everything than in mass production: less human effort, less manufacturing space, less investment tools and less engineering time to develop a new product. A company becomes lean by continuously increasing its capacity to produce high-quality goods while simultaneously decreasing

The question can be argued that why isn’t the approach of running a quality improvement-focused business with the aid of automated process systems being applied to all health care delivery

Training Topic: The training topic purposed is, leader standard work, which is a lean tool that helps leaders to identify what is value-add and non-value-add in their work. Once a leader can identify what is non-value add, they begin to reduce the time spent completing these tasks and spend more time coaching their employees to problem solve and improve patient care. In lean value is determined by what the customer is willing to pay for. Consequently, in healthcare, the customer is the patient. Users of this tool do not have to be formal leaders within the organization, but the intent is to enable individuals to manage their daily, weekly, bi-weekly, and monthly activities strategically and to eliminate the the non-value add activities.

Various methodologies exist for the integration of quality improvement strategies into performance improvement measures. With concepts of total quality management (TQM) and quality improvement (QI) being introduced to health care organizations; administrators have had to decide which methodology is right for the organization. There are numerous methodologies: Six Sigma, Lean, and Customer Inspired Quality. Each has its own pros and cons. A key component of quality improvement is the technology that gathers and compares the data that the quality improvement measure

A manager’s and leader’s role of mentoring, coaching, and facilitating is the key to the Lean process and the continuous quality improvement health care delivery requires. A change in management culture is required if lean is to have lasting success. Fortunately, Optum’s transplant services department is learning to apply lean management on a daily basis including the application of continuous quality improvement of the leader’s journey and the demands the industry presents, including taking time for critical

To facilitate quality improvement initiatives in Ontario, Health Quality Ontario (HQO) has developed a comprehensive Quality Improvement Framework (2013) that brings together several QI science models and methodologies including the Model for Improvement, as well as traditional manufacturing quality improvement methods such as Lean and Six Sigma. Health Quality Ontario grounded their framework in Deming’s System of Profound Knowledge to ensure that the suggested processes could be applied to any quality improvement initiative, in any health care sector. Health Quality Ontario’s QI Framework consists of six phases. Each of the phases is iterative and designed to build on knowledge gained in the previous phase. The phases are:

Table 3 shows characteristics of the seven key informants. Informants had an average continuous process improvement experience at least 22 years with majority of their health care experience being in large academic tertiary hospitals and military hospitals. All of the informants were formally trained in LSS and achieved the certification level of Master Black Belt. In Lean Six Sigma programs, the Master Black Belt certification level is the highest level attainable and symbolizes mastery of LSS topics and experiences in leading large-scale LSS process improvement projects (Gygi, Williams, & Covey, 2012). Key informants provided six common themes to barriers that impacts sustainability of LSS improvements in health care, and are explained below. These six themes were categorized further into two main topics: lack of leadership commitment to drive a culture of quality and inadequately trained and unqualified LSS practitioners to execute LSS projects in health care.

Lean manufacturing is the production of goods using less of everything than in mass production: less human effort, less manufacturing space, less investment tools and less engineering time to develop a new product. A company becomes lean by continuously increasing its capacity to produce high-quality goods while

The Delphi panel stressed the importance of regular performance measuring to ensure improvements are sustained. When staff understood the reasons behind the changes and how they improved the productivity and quality of care for patients, they were more likely to sustain the implementations. Developing a culture with the appropriate elements to support continuous improvement was seen as vital to see success with the lean methodologies.

The purpose of this article was to investigate the usefulness of the Lean methodology in a healthcare setting. According to the authors, there has been an increase interest in the application of Lean techniques in to create “a better, improved, value based healthcare” (D’Andreamatteo, 2015) system. The author examined the status of Lean in the heath care system in various countries by analyzing the available literature regarding the application on the Lean methodology in the industry. The authors focused on two main research questions:

The application and implementation of lean principles or thinking is a process that requires commitment from every stakeholder in the organization. This process entails commitment to the organization's workers and to the system itself in order to make changes towards improvement. Generally, the implementation of lean thinking is geared towards continuous improvement through the elimination of waste. However, lean management or implementation of the principles sometimes incorporate mistakes that are made by leaders in the execution process. This is mainly because lean leadership appears to be simple though its complex because of the costs associated with it. The mistakes usually occur because of intrinsic complexities of exploring deeply into organizational philosophies, business strategy, psychology, and macroeconomics.

Lean is defines the manufacturing philosophy that reduces the time between the shipping and customer demand, which based on the systematic method by eliminating waste, that means giving the customer what they want when they want it, and don 't waste whatever. Rahmana, Sharif and Esa (2013) suggested lean production is mentioned to improve the company 's performance from the philosophy in reducing waste in order. That means, lean system destination is the decrease cost by removing the non-value activities, which they are applying a category of tools and techniques for checking and eliminating defective in the production process. In the Evenort Company should emulate the five overriding principles of lean thinking in terms of implementing lean that there is guarantee the company has been driving correctly in the lean manufacturing (Cardiff 2015) as can show in table 1.

However, Chase et al (1998) identified lean themes as total visibility; respect for people; flexibility; continuous improvement (kaizen); synchronisation and balance; responsibility for the environment and a holistic approach. These two are similar as one must have respect for people while specifying value by putting their needs into consideration, the value stream needs to be identified and made to flow continuously and this can be achieved through synchronisation and balancing, the pull system depicts the flexibility approach and lastly both emphasize continuous improvement.

Lean is a process where creating more value to customers by minimizing wastage, time with less resources. Lean organization understand the customer value and try to increase proceed which adding more value to the business. In order to accomplish the lean thinking