How a lean management approach can improve patient outcomes
Tuesday, September 10, 2019
Lean management: it's an interesting concept in the business world and sounds like a great way to streamline your approach as a hospital administrator. So, what is it, exactly?
Lean management's core principles are that you deliver value from your customer’s perspective; you eliminate waste; and you continue to improve in every way possible as your work progresses.
This sounds like a tall order — but if you do an overview of the way certain hospital procedures are currently handled, you'll see where you should focus your efforts to go lean, and things will fall into place.
Look first at wait times in your ER.
A study from a Monash University research team found that a lean management approach, combined with the Six Sigma system of seeking defects through data, can be very effective.
Meet with your ER team monthly and figure out why they most commonly deal with delays in moving patients. How is time being wasted? Is it through a paperwork log jam? Waiting for callbacks from the lab or radiology? Finding available beds?
The complaints you clock as most frequent are the complaints to deal with first. For example, doing a quality control check with your lab to make sure your ER doctors are getting test results as quickly as possible.
Be a proactive planner.
Researchers from Harvard found that in labor and delivery cases, there were higher rates of C-sections and a greater risk of hemorrhage in patients where communication and collaboration were low and where there were gaps in nurse staffing.
What reduced these issues was proactive intervention: working to improve the way your unit staffers interact quickly and without complication. Another way to streamline your approach: make sure your ORs and blood banks have a stringent reserve system in the event of emergencies by doing multiple scheduled checks per day on available resources. Also, have a plan in place to replenish supply and open up extra surgery space immediately as needed.
Review your mass casualty plan.
Nowhere is a lean, waste-free approach more essential than in the event of a large-scale trauma incident. A study from multiple researchers published by the Society for Disaster Medicine and Public Health found that the more effective responses depend on patient arrival times, which is to be expected.
But at level 1 trauma facilities, patients did better when more beds were made available in internal wards. Meanwhile, in level 3 trauma facilities, patients did better when more beds were opened in the emergency department.
Cultivate core consultants.
Put together a mixed team of doctors, nurses and residents to discuss where time and resources are being wasted within their scopes of practice. Meet on a daily basis to review issues and check on implemented changes.
Ask your patients one simple question.
Either through surveys or face-to-face interaction, ask your patients, "How did we waste your time?" It's a direct query that will illicit honest responses.
You'll find out if call buttons were on too long, if waiting for meals was a problem, or getting a doctor to come by the room was an issue. Your patients will love the fact you asked!
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