Typically entrenched and systemic, healthcare problems require the sort of comprehensive solutions that can only be addressed by a change in culture and a shift in thinking. Applying Lean in Healthcare: A Collection of International Case Studies demonstrates how honest appraisal, intelligent planning, and vigilant follow-up have led to dramatic imp

Typically entrenched and systemic, healthcare problems require the sort of comprehensive solutions that can only be addressed by a change in culture and a shift in thinking. Organizations around the world are using Lean to redesign care and improve processes in a way that achieves and sustains meaningful results for patients, staff, physicians, and health systems. This book demonstrates how honest appraisal, intelligent planning, and vigilant follow-up have led to dramatic improvements in a variety of healthcare settings across the world. It teaches us how innovative organizations can find sustainable solutions to seemingly intractable problems by following a path guided by Lean Thinking. Lean methods may not solve every healthcare problem, but as these cases prove, changing a culture rather than personnel results in more effective sustainable change. This multi-authored book provides expert descriptions of Lean methods and their application in healthcare, written by the people who developed and tested the methods in healthcare settings. Each chapter brings together a description of the technique or approach, with examples of application in practice from the author’s own practice. Authors use an engaging approach to their narrative, with examples from their personal experience or engagement being described to illustrate the practical application of theoretic approaches. In painting a picture of the environment in which these tools and techniques have been applied, readers will understand the transferability to their own workplace environment. This will be an opportunity to tell real stories of the application of Lean in healthcare and give readers the opportunity to learn from people from across the world, on subjects on which they are acknowledged topic experts, based on day-to-day Lean practice.

The book shows readers exactly how to use Lean tools to design healthcare work that is smooth, efficient, error free and focused on patients and patient outcomes. It includes in-depth discussions of every important Lean tool, including value stream maps, takt time, spaghetti diagrams, workcell design, 5S, SMED, A3, Kanban, Kaizen and many more, all presented in the context of healthcare. For example, the book explains the importance of quick operating room or exam room changeovers and shows the reader specific methods for drastically reducing changeover time. Readers will learn to create healthcare value streams where workflows are based on the pull of customer/patient demand. The book also presents a variety of ways to continue improving after initial Lean successes. Methods for finding the root causes of problems and implementing effective solutions are described and demonstrated. The approach taught here is based on the Toyota Production System, which has been adopted worldwide by healthcare organizations for use in clinical, non-clinical and administrative areas.

Effective healthcare delivery is a vital concern for citizens and communities across the globe. The numerous facets of this industry require constant re-evaluation and optimization of management techniques. The Handbook of Research on Healthcare Administration and Management is a pivotal reference source for the latest scholarly material on emerging strategies and methods for delivering optimal healthcare opportunities and solutions. Highlighting issues relating to decision making, process optimization, and technological applications, this book is ideally designed for policy makers, administrators, students, professionals, and researchers interested in achieving superior healthcare solutions.

A growing, aging population; the rise to epidemic proportions of various chronic diseases; competing, often overlapping medical technologies; and of course, skyrocketing costs compounded by waste and inefficiency - these are just a few of the multifarious challenges currently facing healthcare delivery. An unexpected source of solutions is being imported from the manufacturing sector: lean thinking. Lean Principles for Healthcare presents a conceptual framework, management principles, and practical tools for professionals tasked with designing and implementing modern, streamlined healthcare systems or overhauling faulty ones. Focusing on core components such as knowledge management, e-health, patient-centeredness, and collaborative care, chapters illustrate lean concepts in action across specialties (as diverse as nursing, urology, and emergency care) and around the globe. Extended case examples show health systems responding to consumer needs and provider realities with equal efficiency and effectiveness, and improved quality and patient outcomes. Further, contributors tackle the gamut of technological, medical, cultural, and business issues, among them: Initiatives of service-oriented architecture towards performance improvement Adapted lean thinking for emergency departments Lean thinking in dementia care through smart assistive technology Supporting preventive healthcare with persuasive services Value stream mapping for lean healthcare A technology mediated solution to reduce healthcare disparities Geared toward both how lean ideas can be carried out and how they are being used successfully in the real world, Lean Principles for Healthcare not only brings expert knowledge to healthcare managers and health services researchers but to all who have an interest in superior healthcare delivery.

It has been almost 20 years since the Institute of Medicine released the seminal report titled, Crossing the Quality Chasm. In it, the IoM identified six domains of care quality (safe, timely, effective, efficient, equitable, and patient-centric) and noted a huge gap between the current state and the desired state. Although this report received a great deal of attention, sadly there has been little progress in these areas. In the U.S., healthcare still has huge disparities, is inefficient, and is fragmented with delays in care that are often unsafe. Most U.S. citizens are expected to suffer from a diagnostic error sometime during their lifetime, not receive a large fraction of recommended care, and pay for one of the most expensive systems in the world. Much has been written about quality improvement over the years but many prominent quality and safety experts. Yet progress has been slow. Some have called on the healthcare professions to look outside of healthcare to other industries using examples in nuclear power and airlines for safety, the hotel and entertainment industry for a ‘customer’ focus, and the automotive industry, particularly Toyota for efficiency (Lean). This book by Dr. Oppenheim on lean healthcare systems engineering (LHSE) is a fresh approach that brings forth concepts that systems engineers have used in huge national defense projects. What’s unique in this book is that these powerful system engineering tools are modified to be able to address smaller sized healthcare problems that still involve similar problems in fragmentation and poor communication and coordination. This book is an invaluable reference for a new powerful process named Lean Healthcare Systems Engineering (LHSE) for managing workflow and care improvement projects in all clinical environments. The book applies to ambulatory clinics and hospitals of all types including operating rooms, emergency departments, and ancillary departments, clinical and imaging laboratories, pharmacies, and population health. The book presents a generic rigorous but not mathematical step-by-step process of integrated healthcare, systems engineering and Lean. The book also contains the first major product created with the LHSE process, namely tabularized summaries of representative projects in healthcare delivery applications, called Lean Enablers for Healthcare Projects. Each full-page enabler table lists the challenges and wastes, powerful improvement goals, risks, and expected benefits, and some useful descriptions of the healthcare system of interest. The book provides user-friendly solutions to major problems in healthcare delivery operations in all clinical environments, addressing fragmentation, wastes, wrong incentives, ad-hoc and stove-piped management, lack of optimized processes, hierarchy gradient, lack of systems thinking, “blaming and shaming culture”, burnout of providers and many others.

Is Lean a fit for your healthcare organization? Various methodologies can be used to help organizations achieve their objectives depending on their criteria: lowest risk of failure, fast to resolution, or lowest cost for deployment. But what every organization should consider is which methodology will have the greatest impact. Lean, a systematic approach to understanding and optimizing processes, may be the fit for your organization. Learn more in this new IBM® RedpaperTM publication, A Guide to Lean Healthcare Workflows, by Jerry Green and Amy Valentini of Phytel (An IBM Company). The paper delves into the five steps of Lean: Define value from the patient's perspective Map the value stream, and identify issues and constraints Remove waste, and make the value flow without interruption Implement the solution, and allow patients to pull value Maintain the gain, and pursue perfection It describes each step in-depth and includes techniques, example worksheets, and materials that can be used during the overall analysis and implementation process. And it provides insights that are derived from the real-world experience of the authors. This paper is intended to serve as a guide for readers during a process-improvement project and is not necessarily intended to be read end-to-end in one sitting. It is written primarily for clinical practitioners to use as a step-by-step guide to lean out clinical workflows without having to rely on complex statistical hypothesis-testing tools. This guide can also be used by clinical or nonclinical practitioners in non-patient-centered workflows. The steps are based on a universal Lean language that uses industry-standard terms and techniques and, therefore, can be applied to almost any process.