Lean Healthcare: We Got The Money-Now What?

I want to start things off by saying that I comehappen). Initially, everyone will feel good that they
to the table not only bringing a problem, but alsoare fixing the concerns and improving the service
the solution. Most of us are skeptics and arebut this feeling of accomplishment will soon start
concerned that the money recently handed outto turn to frustration again and the money will be
will not be used to improve the patient care in ourused up.
healthcare system. Even with the best intentions,- The 'Right' Choice - Focus our energies on
the money may get diverted to areas, whichunderstanding the current 'systems' and
may have little impact on the real systemicdetermining how to implement a proper plan that
healthcare problems. As you read this article, youwill create better service to the patient while
will discover there is a way to ensure that themaking it faster and less costly - understand the
changes and investments of the dollars have thepotential of the current system and transform it
desired outcome on healthcare. It only requiresto maximize it's effectiveness so we don't buy
passion and a solid strategic plan forunnecessary equipment and assets. We need to
implementation.remove the existing 'waste' by following a Plan
Over the last few weeks, there has been a greatthat gives' system' improvements that will impact
deal of press and conversation about Canadianthe patient/client.
Healthcare. The politicians are dividing up a pot ofLean Healthcare The Method
newly found money for healthcare and the publicIf we don't do this, then 'how do we know how
is wondering why the waiting lists for many ofmuch more equipment we need, how much more
the critical care areas are so long. It appears thespace and people we need?' By understanding our
healthcare system is broken down.Current State and removing the 'waste' to create
Growing up in Canada, the one differentiatorthe desired or Future State, we will be able to
between Canada and the rest of the world wasmake very effective decisions on doing what is
our fantastic healthcare, which served allright. We won't waste our time on doing 'point'
Canadians. We were the envy of all countries.improvements (we call it 'Exciting Chaos') that do
Today, the envy has turned to smirks andlittle or nothing to improve the service to the
sometimes laughter created by the dissatisfactionpatient and has little impact on improving the
and frustration of the present healthcare servicequality and costs.
that is received.Map the current state of the entire 'system' (end
Canadian Healthcare Factsto end including information/communication
I caught the end of a talk show the other daythrough the actual hands-on activities), identify all
and within the span of 20 minutes I heard somethe value and non-value activities, determine the
astounding healthcare facts:present Turnaround Times TAT, determine the
- Canadians in the Ottawa and Regina area canpresent costs and quality issues. Once that is
wait between 50 and 70 weeks for an MRIcomplete (takes normally a day), then design a
- Doctors who work in hospitals make on averageFuture State (6 months out) which removes the
only $95, 000 per yearpure waste in the system (takes a day or two),
- Midwives make 4 times as much asdevelop and detailed Implementation Plan (two
Obstetricians when delivering a babydays max) that outlines the tools, the people and
- A cook in a hospital makes approximately 50%the sequence of events to remove the waste
more than a cook in the private industryfor the entire system.
The number of healthcare administrators makingLean Healthcare Results
more than $100,000 per year has tripled sinceThis Plan will tell us where we need to spend the
1996$$ and effort and will maximize the impact to the
» There are 55,000 administrators inpatient and the budgets of the organizations.
healthcare - more than the number of actualThen, and only then, will we be able to accurately
healthcare providersdetermine what equipment purchases and building
Lean Healthcare Potential Solutionsrequirements are needed. Then execute the
If these facts are even partially correct then IImplementation Plan and get immediate results.
must agree the 'system' is either broke or on theWithout an Implementation Plan the moneys will
verge of breaking.be wasted and just mask the problems so that
As with any problem there are several options:we have to go after even more $$ n the coming
- Do nothing - doing nothing is just not an optionyears. The results we have experienced are
for any of usgreater than 50% improvement (within 6 months)
- Privatize parts or all of the system -using the existing assets.
privatization may be the answer if the currentNote: We are working with a world-renowned
environment can't be fixed or parts can't be fixed.healthcare provider and hospital in the U.S. and
This option brings in emotional as well as practicaltheir waiting list for an MRI is 2 to 5 days and
issues and challenges. Most Canadians expectthey want to get better.
equal access to all levels of medical treatment andIt is a simple process. The politicians have done
the amount of money in your bank accounttheir job of dividing up the money, so let's not
should not be the main factor in determining whowaste this opportunity to make everyone of
gets treatment and who doesn't.those dollars have the desired impact and result in
- Pour a ton of money into all areas to'doing more with less and doing it faster and
compensate for the present problems - pointbetter'!
improvements - pouring money into parts of aLet's choose the best option and become the
broken system without a proper understanding ofenvy of the world again and more importantly
the entire system and the interconnectivity ofstart saving more lives! It's our choice to make,
each part will only sub-optimize the results andlet's not throw the opportunity away.
more than likely hide the problems. And while weRemember in order to get a better result; we
are hiding the problems they will of course gethave to stop doing the same things we did that
worse and be tougher to solve down the roadgot us in this predicament in the first place!
when they surface again (which will definitely