What Hospitals can learn from matured Lean Manufacturing?

What Hospitals can learn from matured Lean Manufacturing?

There is a long-standing scepticism within the Hospital system that there are not many Hospitals that can take away from the manufacturing industry, more so from car manufacturing.  One of the original developers of the Toyota Production System, Mr. Shigeo Shingo once said, “It doesn't matter if you’re making rice cakes or building automobiles, the concept of waste is still the same”. This is indeed profound.

Let's look at it carefully, what is the common ground here? between a Hospital and Manufacturing? It’s not about improving the value-added content of work or working faster, it's about identifying those things that get in the way of value-adding work. 

In the KAIZEN™ way of looking at work, it is often found here is a very small percentage of work that is truly valuing adding (from a customer/ patients view), the rest of it is all waste – this waste gets in the way of value-adding work. Call it an obstruction to FLOW of value-adding work.  Often the structure of workflow is an issue, what with functions/ departments becoming “silos” with patient services having to cut across these silos, causing a lot of obstructions and pain to patient services.


The common current state/ conditions within Hospitals are good people working within broken systems. 

They have unhappy customers, supervisors, /team members leading to frustration and management issues. 


They are little or no time to focus on process improvements. 


Organizational norms and habits are hard to break. 


They waste lots of money with the inventory. Often hospitals run out of high use inventory and land up with too much low use inventory. They hoard and hide inventory to guarantee availability. 


They lack standardized work procedures. 


They have a high/ low volume and high/ low mix.  


They waste valuable time searching for tools, supplies, equipment and information.  


They have long changeovers (equipment in operating theatres & within patient rooms) 


They have too many forms to fill out  


They struggle to make measures meaningful or to guide improvements. 


And such challenges and many more! 

Here are a few quick takeaways from Manufacturing to a Hospital contact,  


Adopt and drive Five S. Less clutter, ease of locating items, good signage, and easy “wayfinding” is paramount in every hospital. Hygiene and high-quality cleaning practices in operating rooms, patient rooms, etc is vital. 


Five S also helps create a Daily KAIZEN™ culture within the hospital  


A scientific way of problem-solving (PDCA) through current state diagnosis, root cause identification, implementing countermeasure, checking results, and acting based on results, is another idea that can be adopted by hospitals.  


Healthcare could learn how to develop an internal logistics/ material handling function to move material frequently, multiple times per day, to the patient floor through the Mizusumashi concept. 


Hospitals can use pull planning to connect and synchronize different areas within the hospital system. Use pull systems to improve patient flow, for example, Pull planning to use between central sterile department to operating rooms, central materials to inpatient floor point of use area, move materials to labs, pharmacy etc. 


Healthcare could learn to use One Piece Flow/ U shaped cells in Labs, Pharmacy, central sterile department. 


Takt Time could use to level work and determine the staffing of both nurses and doctors. 


Quick Setup - concept to reduce changeover time in operating rooms, patient rooms etc. 


Hospitals could learn how to develop a successful employee idea capturing system. 


The hospital can use simple mistake-proofing devices to eliminate human error. 


Use TWI, JI – Job Instructions to transfer skills rapidly  


Adopt Visual Management & checklists to eliminate medical errors. 


Not but not the least, policy deployment and a balanced scorecard to connect and align the organization across with a KPI cascade.  


During the 1990s, when companies started to implement Lean production concepts in Manufacturing, it was started as a method to cut cost, lay off people, work around status quo, lack of transparency, lack of respect for people, little or no top management engagement and most initiatives were tactical, not strategic (even now). Unfortunately, even today a whole lot of companies implement Lean to get short term gains with superficial improvements.  

However, Hospital can learn from the shortcoming/ mistakes that Manufacturing has faced and probably adopt what the Kaizen Institute, after its thirty+ years of global operations, and countless deployments has to offer in terms of KCM - KAIZEN™ Change Management (KCM) model. This model emerges as a comprehensive system to improve customer experience or patient experience, help the development of people, make problems visible, build constructive dissatisfaction with the status quo and help senior management engagement focus on the true north. 


Hospitals can stand to gain if they adopt a systematic improvement model and approach on the lines of KCM.    


Author


Venkatesh Pandarinathan, Senior Consultant at Kaizen Institute


About Kaizen Institute

Kaizen Institute is the original and premier provider of KAIZEN™ services of Change Management, Business Excellence, Operational Excellence and Lean. 

We support companies of all sizes in all market segments, providing them with a sustainable, competitive advantage. Our Vision is Improving the world with Everyone, Everywhere, Every Day – The KAIZEN™ Way. “KAIZEN™ means Change for the better.” 

Kaizen Institute is a global organization that provides consulting and training services to companies represented in Europe, the Americas, Asia-Pacific, the Middle East and Africa. We are currently operating in 60+ Countries for 35 years. 

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