"Lean" Health Care????

ak127 · Aug 2, 2006

I have an aunt who works for a company that teaches facilities how to apply the Lean/Six Sigma concepts. As she has explained it to me, it was originally a manufacturing concept developed by Toyota. Its about little change that make a big differece. Her company goes into factories mostly, and tells the managers things like,

"If you move these two machines so they are close to one another, the worker saves twenty steps, multiplied over two hundred trips per day, multiplied over the year saves you forty bajillion dollars."

I have heard of it being applied to health care. I remember reading about it in a magazine, Newsweek or something last year. The hospital had reinvented its outpatient cancer care to have thier patients get care in one place. Before they went to the lab, then saw thier doctor in his office, then going for scans, then going for chemo, which took ALL DAY and was very tiring. Now, they put the patients into sunny rooms with aroma therapy and relaxing music and the practitioners come to THEM. The unit has its own independant lab, and the doctors actually spend on average more time on patients but less time at work due to more streamlined paperwork.

The nurses always know where their patient is, because they don't usually move. Its much easier to take care of them because they are happier too. One patient said his visit/treatment days which used to take 8-10 hours now take only four.

Sounds good, but I've never seen it in practice. Just don't be scared of the name, its all about standardizing (all the surgeons use the same kind of x-lap tray instead of Dr. A likes this and Dr. H likes this one, or moving things close together to save time). Give it a chance, if you don't like it, there are plenty of hospitals that don't use it!

zenman · Aug 2, 2006

This has been around the business world since Edwards Deming went to Japan after WWII and taught them that they could in fact beat the socks off us!

niccikatie · Aug 3, 2006

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begalli · Aug 3, 2006

This sounds interesting, I've never heard of it. I will check this thread often for more responses.

I just want to say one thing. I just hope that because the number of steps a nurse takes during a shift is reduced or whatever else is done to make our job just a little bit better, they don't also decide that that ju$tifie$ a move to increase a nurses workload.

I really don't mean to be negative. This really sounds like it has many benefits for patients as well, but this whole thing takes me back to the devastating "re$tructuring" of the mid 90's.

JohnBee · Aug 3, 2006

. as she has explained it to me, it was originally a manufacturing concept developed by toyota.

just for the record six sigma was first developed by motorola back in the mid 80's. since then lots of companies use the process.

willie03 · Aug 3, 2006

We do Lean at my facility. I'm pretty new, but I know that it has really created some improvements for us. One one unit they cut down each RN's footsteps by 8,000 per day. Sometimes it feels like they make it worse before it gets better, but from what I've seen it's a very positive move.

Did special trainers come in to your facility to trained? Or did they send certain ones to a seminar to be trained? Or did they fly by the seats of their pants, which is what I think is going to happen where I am. :uhoh3: And did they make the nurses all wear pedometers to prove to cut in steps? LOL! Thanks for the reply>

willie03 · Aug 3, 2006

This sounds interesting, I've never heard of it. I will check this thread often for more responses.
I just want to say one thing. I just hope that because the number of steps a nurse takes during a shift is reduced or whatever else is done to make our job just a little bit better, they don't also decide that that ju$tifie$ a move to increase a nurses workload.
I really don't mean to be negative. This really sounds like it has many benefits for patients as well, but this whole thing takes me back to the devastating "re$tructuring" of the mid 90's.

I had never heard of it until recently either. Theoretically, it does sound like there could be benefits for both patients and care givers. I know that the principles have been adapted to the medical setting, but I guess I am just leery of something that was originally designed for business/manufacturing. And I remember a few years back when we were told to conduct customer service like Disney. :uhoh3: I try to stay positive about change, But I do have a gut feeling that this is all about the bottom line and could end up meaning more work for us.

begalli · Aug 3, 2006

I know that the principles have been adapted to the medical setting, but I guess I am just leery of something that was originally designed for business/manufacturing.

And this is exactly what gives me hesitation. I just don't like the idea of a group coming in thinking they can improve my job without really knowing what my job entails. JUST like the restructuring of the 90's.

It's more for administration and the bottom line, not for the people who really run the place.

Retired R.N. · Aug 3, 2006

Is this just another name for the process called Work Simplification that was made popular by Lillian Gilbreth back in the 1920's and '30's, and is now included in almost every industrial engineering college curriculum?

Otessa, BSN, RN · Aug 4, 2006

Yes, I am a Quality Improvement RN and we use the Lean process as well as Six Sigma for process and performance improvement.

Otessa, BSN, RN · Aug 4, 2006

And this is exactly what gives me hesitation. I just don't like the idea of a group coming in thinking they can improve my job without really knowing what my job entails. JUST like the restructuring of the 90's.
It's more for administration and the bottom line, not for the people who really run the place.

That is an EXCELENT point!! I was a staff nurse until 6 months ago-I've been in healthcare for 18 years and 14 as an RN. BECAUSE I was a staff nurse and could still be a staff nurse was why I was hired. I continue to work 8-12 hours/week in the Float Pool(ICU, ER, Orthos, Med/Surg-you name it) I feel I have no right to make Quality Improvements if I don't live it-validity is key.