Value Stream Management for Lean Healthcare

ISE 491 Fall 2009

Process Improvement in Healthcare - Lecture 3

Contemporary Quality Movements

Six Sigma Customer-focused statistically-based methodology for

reducing defects <Tapping, et al> Voice of the Customer, designed experimentation to

minimize variation and root-cause analysis Lean

Philosophical approach that works to eliminate waste or non-value added activities while improving process flow <Tapping, et al>

5 S, visual controls, mistake proofing, kanbans Lean Six Sigma – combination of both

methodologies with an emphasis on identifying waste and reducing defects

Fall 2009 Lecture 3 Slide 2 ISE 491 Dr. Burtner

Lean Healthcare

Pressure on the Healthcare to Become Leaner Consumers’ increasing awareness of the inefficiencies in healthcare Changing practices of payers (federal government, private insurance,

individuals) HHS (hospital compare) CMS policy toward never events

Healthcare Customers The ultimate customer in healthcare is the patient The healthcare system is comprised of multiple internal customers and

suppliers Customers are also stakeholders

Implementation in Healthcare Applied throughout a complex system (Broad application) Adopted quickly by various departments with minimal training Results seen “immediately” by internal and external customers

The Right Methods at the Right Time???

Fall 2009 Lecture 3 Slide 3 ISE 491 Dr. Burtner

Potential Obstacles to Lean Healthcare 1

Culture of organization or department “It’s not my job” attitude Lack of vision or purpose from upper

management Lack of capable processes and standards Fear of change Inadequate training

Fall 2009 Lecture 3 Slide 4 ISE 491 Dr. Burtner

Potential Obstacles to Lean Healthcare 2

Financial constraints Departmental silos

Lack of departmental communication and co-ordination of care or information

Governmental regulations Legal constraints Safety concerns Certification/licensing requirements

Fall 2009 Lecture 3 Slide 5 ISE 491 Dr. Burtner

Benefits of Value Stream Management as described by Tapping et al

Focus improvement efforts toward a single customer or patient process

Prevent scope creep Allow for departmental areas to be improved with

minimal resource allocation Allow resource coordination/allocation across the

organization Allow for a means of moving from the current state to

the future state Provide a structure for the process owner with the

necessary skills to initiate projects more frequently Allow Lean to be understood in everyday terminology

Fall 2009 Lecture 3 Slide 6 ISE 491 Dr. Burtner