| p>Introduction | | | | treat more patients without investing additional capital. |
| U.S. hospitals are in for a transformative awakening. | | | | According to Jon Scholl, a partner and managing |
| They are facing the most sweeping change to health | | | | director at BCG, a hospital with 800 beds that cuts |
| care since Medicare was enacted in the 1960s. The | | | | average length of stay by just 10 percent can free up |
| Patient Protection Act recently signed into law, | | | | nearly 80 beds per year, enabling the delivery of more |
| fundamentally alters the healthcare landscape for all | | | | than 4,000 additional procedures and boosting |
| hospitals and medical care facilities. Demand for | | | | operating profit by almost $30 million. This approach |
| services will increase astronomically, as 30 to 40 million | | | | effectively "builds" new beds for the hospital. With new |
| individuals become insured, this demand will spike in | | | | construction costs averaging $1 million per bed today, |
| 2013 and 2014. | | | | "another $80 million in averted capital can be realized," |
| Improving throughput in hospitals and medical care | | | | says Scholl. "If you can lower length of stay by 10 |
| facilities will become a challenge, calling for improving | | | | percent, just look at the incredible leverage a hospital |
| process efficiency and labor productivity, at a time | | | | has." |
| when most hospitals are already at their capacity limits. | | | | Lean Hospitals do more than implement just tools and |
| Experts predict that the Emergency Rooms will be the | | | | technical methods. Lean is also a cultural change and a |
| hardest hit, where non-critical wait times may be as | | | | management system, a transformation that takes time, |
| long as four hours. Improving productivity will have | | | | effort, and persistence. Hospitals should not expect |
| even more meaning with the predicted shortfalls in | | | | results overnight because Lean is a journey not a |
| nurses and doctors. | | | | destination. Lean hospital value leaders are |
| Pricing pressures from insurance providers, plus new | | | | implementing infrastructures that all too familiar to a |
| rules from Medicare and Medicaid are threatening the | | | | Lean manufacturer - Lean practices training, internal |
| financial viability of for profit and non-profit healthcare | | | | consultants/experts, or Kaizen Promotion or Center of |
| institutions. The cost of poor quality will now have to | | | | Excellence Offices. Lean Hospitals are making |
| be absorbed by the hospitals. | | | | significant training and development investments to help |
| Although the Patient Protection Act doesn't become | | | | teach their managers how to become true leaders by |
| fully effective until 2013 now is the time for hospitals | | | | empowering their employees and driving continuous |
| and other healthcare providers to start implementing | | | | process improvement. |
| changes in the way they do business. Hospitals must | | | | Some Lean Hospitals use a primarily Kaizen Event |
| transform the care delivery system and create a new | | | | driven event methodology, although the method is |
| model free of non-value-added steps, and provide high | | | | sometimes called "Rapid Improvement Events" or by |
| quality care to the patient. | | | | another name in healthcare. Other hospitals have |
| The Need for Change | | | | taken an approach that focuses less on short events |
| The need for change in healthcare has never been | | | | and more on creating the infrastructure to drive |
| more apparent than it is today. Healthcare is by far the | | | | improved process performance. As the leading Lean |
| largest industry in the United States. It is on the edge of | | | | Hospitals are about five years into their journey, time |
| astronomical growth as baby boomers reach their | | | | will prove which model (or models) will be the most |
| sixties and the impact of the recently enacted Patient | | | | sustainable. As in manufacturing and other service |
| Protection Act. The demand for new physicians will | | | | organizations, Lean Hospitals will have to guard against |
| continue to grow even more rapidly than the supply of | | | | regressing to old practices or behaviors. |
| practicing physicians. The Council on Graduate | | | | Conclusion |
| Education predicts that the nation is likely to experience | | | | Lean process improvement isn't a new concept, but it |
| a shortage of 85,000 to 96,000 doctors by 2020. The | | | | is relatively new to health care. There are many |
| health Resources and Services Administration predicts | | | | skeptics who believe Lean is a manufacturing strategy |
| that the national nursing shortage will exceed 800,000 | | | | and is not suited for medical care. Like the |
| by 2020. Hospitals must take action and learn to do | | | | manufacturing industry, hospitals are in fact, |
| more with less. Lean process Improvement has the | | | | extraordinarily complex organizations, with multiple |
| very real potential to update the care delivery process | | | | interacting processes. Many of the principles of the |
| to one that flows, mistake free, and delivers value | | | | Toyota Production System and other lean tools can |
| from the standpoint of the patient/customer. There is, | | | | and do apply to medical care delivery processes. |
| however no time to waste. The time for action is now. | | | | Courageous, out-of-the-box thinking health care |
| Can lean techniques help hospitals increase efficiency, | | | | organizations such as the Mayo Clinic, ThedaCare, and |
| streamline processes, and improve patient outcomes | | | | Virginia Mason along with others, are leading the way |
| and patient satisfaction? In a special report on how | | | | by demonstrating that lean process improvement can |
| lean processes can transform businesses beyond the | | | | reduce waste in health care and are achieving similar |
| shop floor, experts from Wharton and The Boston | | | | results as other industries. |
| Consulting Group (BCG) explain how it is possible to | | | | Lean principles hold the promise of reducing or |
| accomplish these goals. | | | | eliminating wasteful activities, costs, and inefficiencies in |
| Length of patient stay is a critical measure of | | | | health care, creating a system that provides value to |
| effectiveness and efficiency. A shorter stay means | | | | patients. |
| that beds turn over more quickly and hospitals can | | | | |