MDNews - Central New York

++ + ++ + Working With The Lean Process Review By Mark Dengler "C RISIS!" Considering astronom- ical costs, substandard quality and patient dis- satisfaction, this one word can be used to describe today's American health care system. Across the country, more and more health care providers are realizing the need to implement strategies that will improve quality and safety while simultaneously eliminating waste in order to respond to this health care crisis. Donald Berwick, M.D., administrator, Centers for Medicare and Medicaid Services, is championing this initiative with his "triple aim" plan. Health care reform activities are targeted to mitigate our health care crisis. The Lean process review is a fundamental management tool and can be used to provide better quality for the patient and increase effi ciency within all medical practices. First developed and implemented by car manufacturer Toyota between 1945 and 1970, the Lean process review works with continuous improvement to achieve effi cient processes in production for the provision of services. The Lean process review has gradually spread to other industrial sectors, including health care, and is considered the "how to" of managing change and creating continuous improvement. It's a way to transform an entire organization into a safe and high-quality, high-performing health care delivery system. Burdensome information technol- ogy systems, worker frustration and unintentional errors that can increase patient safety risks act as hindrances to an organization's goal of excellence. The Lean process review can eliminate these factors. In addition, few improvements require costly or sweeping high-tech fi xes. In most cases, simple, well-designed interactions based on scientifi c observa- tions and experiments bring nearly unimaginable improvement fast. To have a long-term effect, the Lean process review must be incorporated into the organization's philosophy. While many health care systems are implement- ing the Lean process review, some are finding achieved improvements are temporary. Day-to-day operations over- whelm standard work processes that have been set in place, resulting in a setback to the overall goals, despite substantial initial improvements. To maintain the Lean process review improvements, there needs to be a change in employees' work and minds. An entirely new employment culture needs to emerge. The Lean process review must be implemented as a system — not just a set of tools — and every level of the organization must be engaged, from executives to management to staff. Every person has a specifi c role to play, and the connections between them are critically important. Health care systems must develop a culture that includes this renewable source of success within the organization. Start Where You See a Problem The fi rst step toward introducing the Lean process review involves confronting reality. It is necessary to clearly identify existing problems in order to make changes. The starting point for health care systems must be recognizing the need to lower costs and improve patient satisfaction (the patient experience). Long waiting times and diffi culties in getting an effi cient fl ow of patients through an exam offi ce or an emergency department are issues that health care providers need to tackle. It is also necessary to have a clear picture of the goals of the business or the organization when you start working with the Lean process review. The team responsible for Lean should work in a very structured way, including mapping out and measuring the impact of changes throughout the process. The work should be followed up in monthly cycles with adjustments made as they are identifi ed. Many teams can work in paral- lel with different processes coordinated by a steering group. However, managers should be involved minimally in the working groups as it is essential that employees themselves are committed to driving the process forward by using their own knowledge and experience. Working through the Lean process review is regarded as a stamp of quality for health care organizations as it helps health care professionals take better care of patients. It involves developing and training health care staff to recognize opportunities to increase productivity, control costs and continuously improve the quality of patient care. Ultimately, the Lean process review helps identify those things that get in the way of improving organizational effectiveness. It is a proven management technique that has provided a broad range of operating processes found in every health care organization. Mark Dengler is the President of Research & Marketing Strategies (RMS), a full- service marketing and market research fi rm located at 15 East Genesee Street (Suite 210) in Baldwinsville. RMS Healthcare, a division of RMS, offers focused, health care- specifi c consulting and research services to health care clients. Contact Dengler at (315) 635-9802 or 1-866-567-5422, or via e-mail at MarkD@RMSresults.com, to see how RMS Healthcare can help you. n +++++++++++++++++++ MARKETING +++++++++++++++++++ + + MDNEWS.COM MD NEWS Central New York | 13

• Cover