Healthcare Lean™
When insurance companies, HMOs and government payers dictate the price, each product and service is an expense, not a revenue source. Healthcare providers must reduce costs.
How Healthcare Lean™ Works
LTG’s Healthcare Lean™ uses value stream mapping, a simple, elegant tool that shows how work is done and how to improve it.
The value stream map:
• Shows the flow of process steps required to complete a product or service from order to delivery • Reveals waste and measures process performance
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Links material and information flow
• Gets people involved in planning and deploying a process improvement plan
Who is the customer in a healthcare value stream?
Healthcare Lean™ is meant to improve, not interfere with, the value-added process -- the encounter of the patient and the caregiver.
The goal is to improve quality by reducing the cost of non-value-added steps, work not reimbursed by the payer. Value stream mapping makes it clear whenever the output of the process is delivered to a customer other than the patient.
Process |
Output of process |
Customer |
Hospital billing - from receipt of voucher to transmitting claim and posting payment |
Transmitted claim, or posted payment, in two hours |
Payer, accounting dept. |
Endoscopy procedure - from patient arrival to discharge |
Increase throughput of preparation and procedure steps by eliminating recovery bottleneck |
Physician |
Physical medicine - from patient arrival to discharge |
Complete and accurate physical or occupational therapy report in one day |
Physician |
Procedure scheduling - from physician inquiry to scheduled appointment |
Scheduled, authorized appointment for a procedure in three days |
Department performing the procedure |
Mapping the value stream
The work group -- employees who know the details of the process -- first draws a current state value stream map to see and understand how work is presently done. The work group measures the process time (the amount of work done to complete a task) and lead time (the total time to provide a product or service from order to delivery). Everyone is aware of the process as it works today, agrees on the current performance of that process, and is involved in planning its improvement.
Workshops
Now is the time to apply the successes of lean thinking to healthcare. LTG can facilitate Healthcare Lean™ workshops for your team. Select:
• Healthcare value stream management
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Healthcare 5S workplace organization
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Pharmacy inventory pull systems
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Healthcare systems
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Healthcare standard work and work balance
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Healthcare problem solving
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Integrated healthcare quality management
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Healthcare built-in quality (error proofing)
The work group then draws a future state map to improve quality and reduce lead time and process time by eliminating waste in the process. Value stream mapping shows where to use lean techniques such as visual workplace, standard/balanced work, one-piece flow processing with cross-trained workers, and pull systems.
The resulting process improvement (kaizen) plan is based on understanding the current state, setting process improvement goals tied to business and operational goals and making a plan to effectively achieve them.
The value stream perspective shows process flow from a systems view, and reveals how to measure performance of that system. Value stream mapping is effective and useful because it makes visible the link between material flow (e.g., scheduled procedure or physician office visit, endoscopy or physical medicine report, or claim for a physician encounter) and information flow (e.g., telephone requests, appointment scheduling software, on-line transmissions from payers).
Healthcare does not need more queuing algorithms. Healthcare needs lean thinking to see processes from a value stream perspective, to understand the role of the patient and the customer in that value stream, and to make use of improvement plans to build in quality, eliminating waste in the process.
To be lean, you must practice lean every day.