Don Berwick's tenure as CMS administrator was short but one thing he came away with was the fact that American healthcare must become radically more efficient. He called out a few high performers. “If you doubt that we know what to do, visit Denver Health or ThedaCare or Virginia Mason, and see the Toyota principles of lean production learned, mastered, adapted, and deployed through entire systems and into the skills and psyches of entire workforces.”
Don recognizes lean delivers better value to customers but value is determined by customers and in this case the customer is our patient.“But, I am not going to apologize. That’s because if you are a student of lean thinking or quality, itself – if you have taken the time to study the work of Noriaki Kano, or Jim Womack, or Taichi Ohno, or Dr.Deming, you know that great leverage in cost reduction comes directly – powerfully – exactly from focusing on meeting the needs of the person you serve. “Waste” is actually just a word that means, “Not helpful.” So, that initial wave of reaction – “Who wants to work on efficiency” – is actually off the mark. In very large measure, improving care and reducing waste are one and the same thing.”
But here is something I don't agree with in the speech. "I would go so far as to say that, for the next three to five years at least, the credibility and leverage of the quality movement will rise or fall on its success in reducing the cost of health care – and, harder, returning that money to other uses – while improving patient experience. “Value” improvement won’t be enough. It will take cost reduction to capture the flag. Otherwise, “cutting” wins".
My disagreement is that quality and cost are fundamentally connected. The lean methodology focuses on eliminating waste which improves quality and lowers cost at the same time. We absolutely need to deliver better value(Q/C) to our customers. Isn't it about time the healthcare industry embraces the lean methodology so we don't resort to "cutting wins".
Berwick Keynote IHI National Forum 7Dec20111
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