3 Tips on Adapting Manufacturing-Based Lean Strategies to Healthcare From Cleveland Clinic

The Lean model of process improvement originated in Japan with the Toyota Production System. Many hospitals and health systems have found the model's principles of eliminating non-value added activity and streamlining processes useful in improving efficiency in healthcare. However, hospitals may need to adapt some of Lean's practices to align more closely with hospital operations and culture. Darryl Greene, executive director of continuous improvement at Cleveland Clinic, came to the health system from engineering. He shares three tips on translating Lean strategies to a healthcare environment.

1. Lead with patient benefit. Hospitals have a patient-centric culture, and as such, proposals for change need to focus on the benefits to the patient, according to Mr. Greene. To gain buy-in and engage staff and clinicians, Lean leaders need to base improvement projects on helping patients first. The benefits to the patient can then ultimately translate into greater efficiency and cost savings.

"Instead of the historic path in industry where energy is more on the cost element, [in healthcare] it has to be more on the patient, caregivers and how [a project] translates into value," Mr. Greene says.

2. Pilot first. The traditional Lean approach to improvement is "ready, aim, fire," Mr. Greene says. For Cleveland Clinic, he changed this approach to "ready, controlled fire, aim, fire." Under this method, an improvement team plans a pilot project (ready), executes the pilot (controlled fire), makes adjustments to the intervention (aim) and deploys it system-wide (fire).

This approach allows Lean leaders to learn about the hospital's or department's culture before instituting a change across the entire organization. "We took this approach because we discovered that this was a totally different world than what we were used to," Mr. Greene says.

3. Time is medicine. In hospitals, "time is medicine," Mr. Greene says. When working with physicians and other clinicians in an improvement team, Lean leaders need to plan meetings in advance so physicians do not feel the Lean project is an intrusion on their patient care. While in manufacturing team members may be readily available for improvement projects, healthcare providers may need more notice before participating.

For example, Mr. Greene says in the past he has had to plan physicians' involvement in a Lean project a month in advance to allow the physicians to adjust their schedules so patient care is not interrupted.  

More Articles on Lean in Healthcare:

How Cleveland Clinic Reduced Cancer Patients' Wait Times by More Than 80%
4 Common Mistakes of Hospitals Implementing Lean Management

4 Steps for Improving Hospitals' Use of Data to Support Lean Initiatives

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