Dr. Leape was quoted in a recent Modern Healthcare article implying lean methods don't work.The following is what he said.
"...while hospital executives have dithered around with concepts like Lean process improvement, which have “industrialized” the system without regard to care."
“Healthcare has become a production system,” he said. “We think more about nursing ratios than we do about nursing. … I don't think most of us think this is progress.”
I have great regard for Dr. Leape but on this one he's got it wrong. We have evidence from many hospitals across the world now that care dramatically improves when processes are standardized and improvement cultures are developed. Lean methodology does both and leads to dramatically better patient and staff satisfaction at the same time.We have shown this at ThedaCare as have others such as Group Health of Puget Sound,St. Boniface hospital in Winnipeg and St. Jorans in Sweden I could list many others.
The basic outcomes of lean include improved quality, lowered cost and improved staff and patient satisfaction. Frankly, if you are not getting all three you are doing something wrong in implementation. I have seen Lean poorly implemented in many institutions and it wouldn't surprise me if Dr. Leape's experience is in a failed implementation hospital.
The good news is the framework for successful implementation is emerging.Certainly Mark Graban's book "Lean Hospitals" has helped. Our upcoming book published by the Lean Enterprise Institute "On the Mend" documents the journey of a successful Lean implementation and my recent series of blogs on this site frames the core components for organizational transformation using Lean.
The anecdotal evidence, however, is not enough that is why the Center along with 5 research institution including Clemson University has submitted a grant to AHRQ which is designed to prove that the lean methodology is superior to other methods in achieving the best patient outcomes.This is a 3 year study that will include matched pair hospitals,those doing lean and those not doing lean, to prove that the methodology works as many of us have described in our articles,books and blogs.We need to prove once and for all, to the scientific community, that the question shouldn't be whether we implement the lean method but how do we do it faster.
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