The Critical Need for Lean Thinking in Healthcare Today

6/8/11

To borrow a term from the military, we live in a VUCA world—Volatile, Uncertain, Complex and Ambiguous. Unfortunately, healthcare’s traditional hierarchical management approach lacks the flexibility, adaptive agility, or innovative energy to meet the challenges of this new world. However, every employee at every healthcare institution has the ability to identify waste and enact long term improvement-they just need a system, training, and the management support to help them do it.

Lean thinking” is a term coined by MIT professors in the 1990′s after they studied Toyota Motor Company to understand the essence of Toyota’s remarkable success. “Lean Thinking” describes a set of deeply held beliefs regarding organization culture and embedded principles that drive continuous improvement based upon customer-driven values. Lean healthcare organizations empower their employees (physicians, nurses, administrative staff, etc.) by teaching them how to identify wasteful process steps and giving them problem solving tools to be used in their daily work as well as on project teams. These patient-centric organizations relentlessly define value in the eyes of their patients and seek to identify and eliminate wasteful work elements from every aspect of their enterprise-both clinical and non-clinical.

For the past three years, Atrius Health has been working with lean management consultants Simpler Consulting to adopt a lean operating platform. Through implementing lean, Atrius Health has begun a cultural metamorphosis, focusing on governance, distributed leadership and local innovation. The results have been steady and are accelerating as more of the organization is trained. In 2010, we saw a return of at least $3.5 million while improving patient care. For example:

• By improving patient flow, the MRI suite at Atrius Health has decreased turnaround time, a net gain of more than $750,000 per annum, decreasing patient wait time

• The Endoscopy suite has improved capacity and access for patients without increasing overhead or staffing costs which resulted in a gain of almost $1 million per year to the practice

As legislation from the “health reform” bill—the Affordable Care Act—continues to go into effect, it is imperative for healthcare leaders to adopt management systems that are patient-centric and redefine the role of management to distribute leadership, responsibility, accountability, problem solving and autonomy to the people who are as close to the patient as possible.

This week, I will be presenting our case for adopting lean healthcare, and why Atrius Health views lean as a strategic initiative at the 2nd Annual Lean Healthcare Transformation Summit in Seattle. The Summit, sponsored by Healthcare Value Leaders, will bring together more than 400 healthcare leaders from throughout the country.

By collaborating and learning with other healthcare organizations, the healthcare industry will be able to tap the collective potential of individuals to continuously enhance the value delivered to patients, their families, and the communities we serve.

Gene Lindsey, MD, is the president and CEO of Atrius Health, a non-profit alliance of five community-based multi-specialty medical groups serving almost 700,000 patients in eastern Massachusetts. Follow @

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