Lean Methodology – BellMedEx

In hospitals, every second matters — nurses rush between rooms, physicians consult on critical cases, and patients anxiously await their turn. Lean healthcare offers a way to bring order to the chaos and transform how care is delivered.

Imagine a patient arriving at the Emergency Room with severe abdominal pain. In a traditional healthcare setting, they might face long wait times, unnecessary paperwork, and clashes between departments. But with lean healthcare, the patient is quickly triaged and directed to a dedicated care team following standardized procedures to minimize delays.

At its core, lean healthcare is built on a few key ideas:

➜ Lean Principles: Maximizing value for the patient while minimizing waste is the driving force. Healthcare professionals are empowered to identify and eliminate non-value-added activities continuously.

➜ Value Stream Mapping: By mapping out the entire patient journey, from admission to discharge, inefficiencies and opportunities for improvement become clear.

➜ Waste Reduction: Any activity that doesn’t add value to the patient’s care is considered waste – whether it’s excessive waiting times, unnecessary movements, or redundant processes. Lean practices help healthcare systems identify and eliminate these wasteful activities systematically.

➜ Continuous Improvement: Lean healthcare is a process that keeps going. It means finding ways to do better, putting those ideas into action, and checking how well they work. It is a process of constant improvement to achieve better results for patients.

➜ Patient-Centered Care: Lean focuses on putting the patient at the center of all processes and decisions. By cutting down on waste and making processes easier, healthcare workers can concentrate on giving the best care experience.

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Overview of Lean Healthcare

The concept of “lean” originated in manufacturing, with the term coined by John Krafcik in 1988. James Womack and colleagues later defined lean more broadly in 1996 as a “systematic approach to identifying and eliminating waste (non-value-added activities) through continuous improvement by flowing the product at the pull of the customer in pursuit of perfection.”

The Triple Aim of US Healthcare was created by the Institute of Health Improvement (IHI). It provides a helpful framework, pushing healthcare systems to simultaneously improve patients’ experience, population health, and per capita costs.

While lean has proven models, each organization must modify these models to suit their own context. Establishing a mindset of constant improvement at all levels is necessary for success. When done correctly, lean healthcare methods can greatly transform care delivery.

Here are some of the definitions of lean healthcare by different Authors:

➀ Black and Miller (2008):

❝Lean healthcare is a patient-focused approach to managing and delivering care that continuously improves work processes. All aspects of the care delivery system are focused on eliminating waste while steadily increasing value-added work. It is premised on the idea that healthcare can be continuously improved without adding more money, staff, space, or inventory.❞

In simple terms, Black and Miller explain lean healthcare as a way to put patients first. It aims to make processes better by removing waste and adding value for patients, all without needing more money, staff, or space. The main idea is that we can make healthcare better by improving how things are done, not just by adding more resources.

➁ Poksinska (2010):

❝Lean healthcare involves understanding what adds value for patients and eliminating waste from care delivery. It often emphasizes that current healthcare systems have fragmented, inefficient processes that require redesigning the flow of patient care.❞

Poksinska highlights that lean healthcare revolves around understanding what is valuable for the patient and eliminating wasteful activities or inefficiencies in care delivery. She points out that today’s healthcare systems often have broken and slow processes. These need to be changed to make patient care better.

➂ D’Andreamatteo, Ianni, Lega, and Sargiacomo (2015):

❝Basic Principles – Specify value from the patient’s perspective, map the value stream, enable uninterrupted workflow, allow patients to pull value, and continuously improve.

Other Principles – Involve all staff in improvement, respect all employees, and integrate suppliers into the value stream.❞

These authors explain important ideas about lean healthcare. The main ideas are: understand what is valuable for the patient, outline the steps to provide that value, keep the workflow smooth, allow patients to start the value delivery, and always work on making processes better. Also, they say that other important lean principles are getting everyone involved in making changes, treating workers with respect, and bringing suppliers into the value stream.

Waste Categories Used in Lean Healthcare

In lean healthcare, waste is anything that does not help make the patient’s care and experience better. Lean principles aim to find and remove wasteful elements, making operations easier and improving efficiency in healthcare.

The concept of waste in lean healthcare is often categorized into eight types:

Defects

Errors can happen in medical procedures due to wrong diagnoses or faulty medical equipment that need fixing. These problems can raise costs, harm patients, and slow down medical care. For example, if a patient is diagnosed incorrectly, it can result in the wrong treatment. This may lead to serious health complications and higher medical costs.

Overproduction

If we make more medical equipment and medicine than we need, it creates waste. This waste can include unnecessary diagnostic tests or treatments that are not needed for patient care. For example, doing too many blood tests for a patient when they are not needed wastes resources and incurs more healthcare expenses.

Waiting

If patient care is delayed because of more waiting time for consultation, test results, medical equipment, or doctor availability