It's All About the Data

It's All About the Data
It's All About the Data

Monday, May 19, 2014

Lean Healthcare - A recent voyage

Healthcare is going through a transformation.  Obamacare is one of the changes.  Other healthcare organizations are promoting the notion of "lean healthcare".  See the following website to get the basics:(

I had the chance to use a hospital touting lean healthcare.  The hospital's goal was stated as "to provide a better user experience and reduce waste".  Luckily, I was not the patient. 

Without going into all the aspects of the experience, here are my observations/concerns:
  • Why ask all the patients to make sure they show up at the same time, only to not have enough administrative staff to check them in?
  • If HIPPA has been around for a while now, why is the queuing process of patients so bad?
  • This hospital used barcodes on the patient tags, but absolutely no one scanned the barcode.  Instead, the process used was to ask me (I was the designated driver) the same set of questions over and over.  I must say they had no sense of humor when I varied my answer slightly each time.
  • Lastly, this was the question that drove me up a wall -  "why are we here every 5 minutes of the pre-operative process?" - does not seem very lean to me.

Okay, so what is my point?  If healthcare, with all its revenue sources, and in general, a fairly consistent and repetitive pre-operative process has these issues, how can other businesses have any chance of being 'leaner'?

  • First, nothing beats employee 'buy-in' to the process.  100% buy-in.
  • Second, the existing process must change to become lean.  You can not force the existing process to be lean, by simply calling it 'lean'.
  • Have a plan and execute on it - get customer feedback (the healthcare organization did not want mine).
  • Lastly, continuous improvement is required.

It is not an easy journey, but  the reward is worth the effort.

David Haynes, PMP, is Director of Consulting at Ideate, Inc. (  David's experience is in providing companies with business process analysis and change implementation.  @dhaynestech.


  1. Great questions. Many hospitals, through Lean, are starting to "level load" their schedules... it's not very patient-friendly to have EVERYONE show up at the same time... that was done for the benefit of the surgeons and the operating rooms (focusing on 100% utilization instead of patient flow).

    I wonder if nurses and staff were "working around" something that didn't work well with the bar code process. At some point, being asked twice to confirm your name and birthdate and why you're there... that's reassuring. At some point, it becomes troubling... because they really apparently don't have a better way of keeping patients straight and don't have a better way to prevent performing the wrong surgery on you or on the wrong side of your body.

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    1. Mark - I appreciate your comments. I have heard you speak and you are certainly knowledgable in the field of lean healthcare. The level load issue is one of supply (water) and production (orifice of the pipe). I can have something be 100% but very un-lean.

      I think that my experience is not unusual, but still frustrating as healthcare is struggling between understanding we don't have alot of options (regulated number of hospitals) and becoming a service (democratizing the process).