LEAN HEALTHCARE

Healthcare organizations face increasing pressures between the rising costs of poviding services to patients and the reimbursement rates dictated by insurance companies, HMOs and government payers.

The Lean transformation principles that were developed for use in a manufacturing environment can be applied to healthcare settings, with the result of reducing costs without reducting services provided to patients.

Healthcare Lean™
LTG's Healthcare Lean™ applies concepts and techniques of the Toyota Production System to hospitals, clinics and physician practices. LTG healthcare clients who have implemented Lean thinking and techniques (see LTG's Lean Healthcare Case Studies) have seen the following improvements:

	•	Same day office visits
	•	No-wait emergency room (see LTG/MHA Keystone Collaborative)
	•	Productivity gains of 62%
	•	20% increase in number of surgical procedures by reducing operating room changeover

HEALTHCARE LEAN
WORKSHOPS
Now is the time to apply the successes of Lean thinking to healthcare.

LTG can facilitate Healthcare Lean™ Workshops for your team.

Select from:

			Healthcare value stream management
			Healthcare 5S workplace organization
			Pharmacy inventory pull systems
			Healthcare systems
			Healthcare standard work and work balance
			Healthcare problem solving
			Integrated healthcare quality management
			Healthcare built-in quality (error proofing)

Healthcare Lean™ makes use of Value Stream Mapping, a tool that shows how work is done and how to improve that work.
~ The value added process for healthcare operations is the encounter of the patient and the caregiver. The intent of Healthcare Lean™ is to improve, not interfere with, that process.
~ The goal of Healthcare Lean™ is to improve quality by reducing cost of non-value added steps, that is, work not reimbursed by the payer.
~ Value stream mapping does this by making clear that the output of the process is delivered to a customer other than the patient.

The following table shows a value stream example in which the customer is not 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 2 hours	Payer and Accounting Dept.
Endoscopy procedure from patient arrival to discharge	Increase throughput of preparation and procedure steps by eliminating recovery bottleneck	Physician
Physician 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 (e.g., chest roentgenogram, colonoscopy, cardiac ultrasound) in 3 days	Resource that does the procedure (e.g., radiology, endoscopy, cardiovascular departments)

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.

Eliminating costly waste from non-value added functions is a great way to increase your organization's net revenues and a vital part of its Lean transformation toward creating a total Lean organization.

LTG is committed to helping you enhance your operations with a Lean transformation - Contact Us today.

LEAN HEALTHCARE CASE STUDIES
Mass General: One of our partners, Guy Parsons, helped Mass General open up capacity in their Radiation Therapy Center.

Mayo Clinic: Mayo is an ongoing client of ours and this story is a great one about not only increasing capacity but generating new business as a result! Good for the patient and good for business!

University of Michigan Health System: The University of Michigan Health System is an ongoing client and this story is one of early successes before our direct involvement. However, there is still a link to us: they used Lean coaches from a nearby company who were trained by us!

Hotel Dieu Grace: Here is a Canadian case study where several of our partners got involved. This was a situation where the initial successes created a real pull to thinking differently about all hospital services. It started here!

Mercy - San Diego: Here is an oldie but goodie - this is first documented case study using Lean thinking in healthcare! This was before value stream mapping came of age (even before the term "Lean" was coined), but you can see what we used and how close it was.