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Building value by becoming Lean
In recent years, the business community has increasingly adopted Lean process improvement principles pioneered in the auto manufacturing industry to produce
goods and deliver services that create value for the customer with the minimum amount of waste and the maximum degree of quality.
Although many assumed the complexities of the heavily regulated healthcare industry would impede the ability to apply Lean to healthcare, the Iowa
Healthcare Collaborative is leading the successful adoption of Lean in Iowa hospitals.
IHC promotes the education of Iowa healthcare professionals in Lean concepts, providing the tools and resources they need to implement Lean practices.
With direction from the Iowa Business Council and the cooperation of healthcare providers across the state, IHC developed a comprehensive Lean in Healthcare toolkit. IHC distributed the toolkit to all Iowa hospitals, and makes it available through the IHC website. The toolkit provides a framework for Lean implementation, including key contacts and resources as well as process improvement success stories from several Iowa hospitals.
IHC also sponsors an annual Lean in Healthcare Conference that brings healthcare professionals across the state together to build relationships and learn
process improvement techniques from one another.
The conferences educate providers through:
- Case studies that illustrate how Lean methodology can be initiated in any size hospital
- Panel discussions and keynote addresses by Lean experts from around the state
- Sessions to instruct professionals on the basic tenets of Lean
While achieving maximum efficiency in our industry will require long-term, sustained commitment, IHC is encouraged by the many successes already being realized throughout the state. For our initial effort to drive Lean implementation "on the ground" in Iowa hospitals, IHC established and facilitates a Lean Learning Collaborative- a group of 21 Iowa hospitals that have committed to implementing Lean process management techniques. Already, 11 of these hospitals have reported $250,000 in waste elimination by making simple operational changes...and we've only just begun.
Getting into top-quality SHAPE at Spencer Hospital
Three years ago when Doug Doorn took over as president and CEO of Spencer Hospital, he says the successful, independent 99-bed facility was "as good as anyone else" in providing quality healthcare to northern Iowa and southern Minnesota residents. Doorn knew they could do better, however, and he immediately began looking for ways to break out of the traditional healthcare quality mindset.
"The myths are that better quality is always more expensive, and requires more staff," he says. "We needed to break out of that cycle of very hard work but no progress. I think of Einstein's definition of insanity-doing the same things over and over and expecting different results."
Doorn and his staff researched several Lean approaches and determined the Toyota Production System process, focused around one-week rapid improvement events, made sense for them.
They named their program SHAPE-Spencer Hospital Achieving Performance Excellence-in recognition of their focus on shaping up to an appropriate level of fitness. The hospital held its first SHAPE event in October 2005, and today have more than 20 events under their belt. Approximately 180 of Spencer Hospital's
500 employees have participated at least once, and in some cases, physicians and patient families have contributed as well.
"I'm very happy with our soft results-the movement in our culture," Doorn says. "In the last two quarters, our patient surveys show 99 percent satisfaction, and we receive lots of feedback from visitors that our staff seems content. We've come a long way in thinking about how we do work. I think we're also seeing huge success in building consistency that results in fewer mistakes."
Doorn says many of the hospital's SHAPE events have identified ways to streamline work through physical changes. "We've cleaned up many of our areas, reduced inventory and improved work flow," he says. In several instances, easy fixes such as moving a copy machine closer to the receptionist desk have saved more than 100 miles of walking and wasted time each year. With new construction, Doorn says the hospital now plans space around workflow rather than aesthetics, which results in less square footage needed, fewer steps for employees, and better workflow.
The hospital currently has one full-time SHAPE coordinator and is adding a second to double its capacity for SHAPE events. "A lot of good things are happening, but once every employee has participated in two events and begins thinking differently about his or her work, our momentum will really be in full swing," he says.
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