Learn what is Lean Healthcare and how this methodology can help save lives!

Lean Helthcare is one of the methodologies inserted in the Lean content and widely used in the health area. It is very important to understand correctly how it works and objectives.

You already know the importance of Lean Manufacturing in the industrial world, isn’t it? Yeah! This Japanese philosophy of great worldwide success has also hit other areas such as health. Now you will find out what Lean Healthcare is and its importance!

You may be asking yourself, "What do you mean? How can something more applied in industries be applied to the health area? "And that's what you'll see in this article! How

Lean is applied in hospitals, clinics, and health clinics.

Here you will see everything about this philosophy, its history, why it goes to the health area, what are the steps you can take to implement, what are the tools used to aid in implementation and finally real examples of success. Check out our topics!

• What is Lean Healthcare?
• Why does the health area need Lean Healthcare?
• 5 steps to implement Lean Healthcare
• What are the Lean Healthcare tools?
• Examples of hospitals that have succeeded in implementing Lean Healthcare. 
• Lean Healthcare really has changed health processes

Are you prepared? So let's go!

What is Lean Healthcare?

Determine the date of implementation and where it started is an almost impossible task but we know that some hospitals began experimenting with this method in the 1990s.

At that time the challenges faced in the health area were very large and complex, making it very clear that hospitals, laboratories and medical units needed to find solutions that were already practiced in other business areas, such as the automobile industry, for example.

After all, what is this Lean Healthcare? It is a set of Lean concepts and tools applied in the health area, aiming to change the way all health homes are organized and managed.

This philosophy allows for better patient care and also promotes the integral engagement of employees and doctors in continuous improvement, seeking to eliminate wastes that don’t add value.

Relating to the health context, as defined by the father of the Toyota Production System, Taiichi Ohno, the Lean should look chronologically at the patient from the moment he is referred to a doctor to perform a consultation or treatment, until the exact time of the care performed.

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Why does the health area need Lean Healthcare?

Answering this question is very easy! In the health area there are several processes with many waste and also activities that do not add value.

These activities hinder health professionals from carrying out their primary mission, which is to provide the best possible personal assistance to the patient and to keep people healthy.

In addition, these problems associated with waste in the Lean can take a lot of time from health professionals, generating great difficulty in creating a welcoming environment for clinical care.

But what are the real gains that Lean Healthcare can generate? Well, I'll list a few of them, and you'll see that this philosophy really can bring great improvements:

1. Increased patient safety;
2. Reduced costs, waiting time and errors;
3. Improvement in the disposition of the teams, among others.

Health area is very delicate and of paramount importance. Any gain can make a difference and can save a life! Therefore, it is desirable to apply the Lean in this area, because the gains will be immense!

5 steps to implement Lean Healthcare

STEP 1: To begin implementing, the ideal is to first choose an area or a value chain, since it is not at all practical to implement the Lean throughout the organization at once.

But how to identify in which area to begin? A good strategy for this is to analyze the strategic motivators or problems that need more immediate solutions. And the main motivators in a healthcare company are:

• Patient satisfaction and safety;
• Waiting time;
• Delayed patient discharge;
• Work quality, among others.

STEP 2: In this second step you should conduct an evaluation in several departments, within two weeks, to map the value chain.

It will be this value chain mapping along with process observation and conversations with employees and patients that can be used to identify waste, rework, and other processes that add no value.

STEP 3: This step aims to identify the opportunities for improvement, either in increasing patient safety, in the quality of work, savings in stock or in the improvement of waiting time.

STEP 4: This penultimate step is intended to use kaizens to solve different types of projects. But what is a Kaizen?

Basically, it is a methodology that allows the operation of the lean system within the philosophy of Lean Manufacturing. It is important to remember that it is a tool that can be adopted in companies of any size.

There are 3 types of kaizen that can be used on this occasion: the kaizen point, the kaizen event and the kaizen system. The latter two will be the most used in Lean Healthcare implementation.

STEP 5: We come to the last step, and he talks about the great importance of change management. But how?

The great challenge of implementing the Lean is related to the difficulty of employees in accepting change. Changing old processes can cause bad impressions. Collaborators can go through a cycle of denial and fear before believing that the improvements will actually come to fruition.

Therefore, a closer relationship between employees and leadership is essential. It should show all the benefits of the implementation and what improvements will be achieved, to make it easier for everyone to accept.

What are the Lean Healthcare tools?

There are some tools that can assist in this Lean implementation process in hospitals, clinics, and health clinics. I will now briefly talk about the most important and most used:

1 - Spaghetti Diagram

Basically it is a tool that helps in visualizing the optimization of a process and that is very easy to apply.

In addition, the Spaghetti Diagram is a great way to visualize the flow in a process and illustrate the wastes that are involved in the transport or movement of the course that has been mapped.

2 - 5S

It is one of the easiest tools to use because it is easy to understand and has the main focus to improve people's behavior and is based on the 5 senses.

Basically, it involves a change of habits and attitudes, improving the work environment, becoming more harmonious and consequently improving the employees quality life.

But what are these famous 5S?

• 1st Sense - Sort: only have what is necessary, separating what is necessary from what is not, avoiding all types of waste.
• 2nd Sense - Set in order: arrange only what is needed using an efficient methodology to facilitate both access and handling. Just tidying up is not enough, you have to establish criteria for ordering, because only in this way you can organize everything effectively.
• 3rd Sense - Shine: this third sense aims to keep the workplace and its equipment totally clean for use. Cleaning should be regarded as a form of inspection, because if there is a systematic view you can detect and correct failures, so that at the time of production, it works to the best possible way.
• 4th Senso - Standardize: it is one of the most important, because it is concerned with the health of employees on a physical, mental and emotional level and also with aspects related to environmental pollution.
• 5th Sense - Sustain: we arrive at the last sense, it aims to create greater respect and commitment towards the company, fulfilling in a disciplined way what was requested.

3 - Visual management

This visual communication system serves to ensure greater adherence to the standards, so as to complete the work according to the schedule and without any errors.

In the health area, visual management is used to define the work scale, to present productivity results, to support bed management and also to assist in the creation of visual signals for the emergency department.

4 - Continuous flow and Kanban

Continuous flow is used in movement, with patients or to provide a service between processes with minimum or no waiting time.

In the health area, to create a continuous flow, the Kanban tool is used a lot.

But what is Kanban? It is a form of communication between processes through colored cards saying exactly what is needed and the term. Speaking of healthcare, Kanban can be used to refer patients for exams, replenish items from stock, and also to supply the pharmacy in a hospital.

5- Poka Yoke

It is also known as an "error-proof device" and is a way of thinking about mechanisms that prevent process errors. The main goal is always to pursue the "zero defect" stage.

I will exemplify the Poka-Yoke in the health area for your better understanding. Imagine a clinical laboratory where to collect blood they need tubes with different colors and shapes to avoid mistakes. This is an example of Poka-Yoke.

Examples of hospitals that have succeeded in implementing Lean Healthcare

The first hospitals that had results with the implementation of this philosophy, were those of the United States.

The first example is the ThedaCare Hospital, located in the state of Wisconsin. It was able to reduce waiting time for hospitalization for orthopedic surgery patients from 14-week to an incredible 31 hours, thereby raising the patient satisfaction rate from 68% to 90%.

Another American example is the Avera McKennan Hospital in South Dakota which, through Lean Healthcare, reduced patient residence time by 29% and generated a savings of more than $ 1 million in the construction of new emergency departments.

These are just a few examples of many that exist. The gains from the implementation are many and the trend is for more and more health care homes to "open their minds" and resolve to adhere to this philosophy, generating good results both for themselves and for patients.

Lean Healthcare really has changed health processes

Lean philosophy has revolutionized various industries in the 4 corners of the world. And now it has arrived in hospitals, clinics and certainly arrived to stay! Even though it is a very young philosophy, it has already brought significant results to various hospitals, as you could see in this article.

I know that this implementation process is difficult but the results are great, and besides improving the process as a whole, it can save lives!

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