Lean in healthcare

Résumé du document

Lean thinking is not a manufacturing tactic or a cost-reduction program, but a management strategy that is applicable to all organizations because it has a role in improving processes. All organizations including health care organizations- are composed of a series of processes, or sets of actions intended to create value for those who use or depend on them (customers/patients)" (Institute for Healthcare Improvement, 2005). Like any industry, Healthcare has a product to deliver (treatment of patients) and the administrative processes that support the care givers, patients, and keep it running as a business. There is huge room for improvement in both of these areas. Both the areas are interdependent and problems in one will have an impact on the other. With the lean way of thinking, we will first determine the value of the actual process by accurately specifying the value desired by the patient; then identify all steps in the process (or "value stream," in the language of lean), underline the non-value-added steps, and eliminate waste (or muda in Japanese). Finally, we will make value flow from the beginning to end based on the pull mechanism i.e. the expressed needs of the customer/patient.

Extraits

[...] Pre-diagnostic done by an emergency team when the patient arrived at the clinic. The pre-diagnostic can be done by the emergency service if they bring themselves the patient. To save time, the clinic can standardize the treatment of information by for example, installing software which generate immediate information: which rooms are available, which operational bloc is available, time per patient . Generating a standard work, by the Kaizen system could provide more efficiency in the clinic management as it permits to get a better communication between all the areas. [...]

[...] Defining the actual process in emergency department 2 II. Value desired by the patient 4 III. The mudas 4 It is a Japanese word which literally means waste: every activity that consumes resources but does not create value as perceived by the customer IV. The value stream Improve the patient wait times by analyzing the causes of an excessive waiting Improve the patient safety Increases Profits 8 V. The flow 9 VI. The pull 9 VII. The perfection 10 Conclusion 10 Introduction Lean thinking is not a manufacturing tactic or a cost-reduction program, but a management strategy that is applicable to all organizations because it has to do with improving processes. [...]

[...] -Standards of the requirement found in a guideline book. -Monitoring and evaluation of the quality of procedures and equipment Increases Profits The Kaizen allows the company to be more efficient in the diagnostic of patient problems, the repartition of information system by monitoring information, and participate to the improvement of the patient care and so, the patient satisfaction. Kaizen system of management look at where are the wasted and errors that could be avoided. In Emergency services, the optimization of time is one of the key factors to be performing. [...]

[...] Putting an (internal) charge on pulled services would be such a mechanism. The perfection “Perfection” in healthcare, it is what the patients all want: correct diagnostic and therapy in a reasonable time. We try to change the process by optimizing patient flow by identifying four major groups of patients: those with minor injuries or illness that could be treated and discharged quickly, those who required longer assessment and observation, those requiring hospital admissions, and patients requiring emergency surgical procedures. To perfect our process, the following points are essentials for us: -Eliminating triage, -Having patients initially evaluated, -Early access to diagnostic, -Test prioritization, -Maximizing the care provided, -Having policies and procedures in place, -Conduct failure analysis, on a daily basis. [...]

[...] One of the early steps of flow introduction is to involve local doctors, in order to channel patients correctly. Another step is to establish flow in the part of the value stream that one actually controls, in this case the emergency department. Flow in Emergencies, will only be achievable once it has been turned into a real 24/7 operation. At present, night cover, be it surgical or medical specialties, is mostly provided by junior personnel in the front line and it has highlighted the danger this practice bears. [...]