Lean Healthcare

Good News! Hospitals are Healing Themselves through Kaizen

By Jon Miller Published on May 16th, 2006

“All the things wrong with hospitals can be fixed.” Narrator Lloyd Dobyns tells us at the beginning of the video program Good News…How Hospitals Heal Themselves
In the video program hospital administrators and clinicians tell us that there is 40% – 50% waste in a hospital system. This can include the familiar waiting time in a hospital to something more serious such as the 2 million people each year who get infections at the hospitals, causing one death every 6 minutes and adding 7 billion dollars to hospital cost.
A lack of training in system thinking, the increasing complexity of patient care due to advanced medical devices and the support staff this requires, and a lack of focus on the patient has resulted in this waste, according to healthcare professionals in the video. Deborah Thompson, RN a quality trainer says “We’ve made a lot of decisions away from the front line of the patient.”
One frightening statistic is the annual increase of salaries in Pennsylvania of 3% and the increase in healthcare costs of 20% to 25%, which by 2008 would cause insurance costs to equal salaries.
PHRI (Pittsburgh Regional Healthcare Initiative) is a group of 40 hospitals plus a few insurance companies and businesses working together to implement TPS in their hospitals. The video gives examples and testimonials of healthcare professionals making data-driven decisions to create patient care standards for doctors and protocols for nurses.
The experience at SSM Health Care in St. Louis, MO emphasizes that healthcare improvement must be a hospital-wide effort and will require culture change. They spell out the three conditions for success:
1. Leadership. Establish goals everyone can relate to.
2. Strive for perfect patient care
3. Use systems thinking
The emphasis on systems thinking, according to the video, is see things with new eyes, seeing the whole hospital system and the processes working together rather than individual tasks. Several testimonials cite the importance of seeing “workarounds” for what they are – problems – rather than normal work and a functional process.
These hospital systems explicitly credit the Toyota Production System as a model used to design and improve work. The video gives excellent examples of 5 why, decision making on the front line, and blame free environment for experimentation and problem solving.
In summary, some of the good news reported in the video from SSM and PRHI:
– Estimated $1.7 million in cost saved from fewer deaths in reduced in coronary bypass problems
– 85% reduction in hospital-acquired infections (at a cost of $40k to $90k each)
– 63% reduction in central line infections since 2001 (half are fatal, the cost is $30k or more to treat)
– Staph infections from 26 out of 1,000 to 8 per 1,000
This video production was funded pro-bono by the producers of the 1980 Deming video on “Japan Can, Why Can’t We?” If your organization is making excuses that “we are different” and that TPS does not apply to you, here is a hospital that proves it can. After all, if a hospital can implement TPS, why can’t you?
I encourage you to support the important efforts to extend Lean thinking and kaizen into healthcare by purchasing this video (neither Gemba nor I benefit from your purchase).
Here is a list of PBS stations that have committed to airing the program. If yours is not on the list, contact your local PBS (Public Broadcasting Service) station and ask them to broadcast this program so the good news about practical healthcare improvement approaches can reach a wider audience.

  1. Mark Graban

    May 17, 2006 - 5:24 am

    This is indeed an excellent video. Healthcare is too important for us, we have to use lean thinking to improve this sector. The DVD also comes with a book that looks very promising. I’ve seen the introduction (it’s available for download on managementwisdom.com) and it will ship out after the DVD, but it’s included in the price.

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