Lean Healthcare

A Fairly Lean Healthcare Experience

By Jon Miller Published on April 9th, 2007

I hope everyone who celebrates Easter had a good Easter Sunday, and those of you who don’t also had a good weekend. Thanks to a culture change in my throat brought on by some visiting Streptococcus, I didn’t have a good weekend. A few amoxicillin pills later, I can reflect on the experience. It was fairly Lean, as healthcare experiences go.
This morning I called up the local clinic at 8AM and they had openings at either 1045AM or 2PM. I picked the earlier time. They asked me to arrive 15 minutes early to get registered as a new patient. There was a PDF on their website to download, print and fill out at home.
The clinic housed eight doctors. There were two more pieces of paper to fill out, mostly to do with details of my medical history and my rights regarding that information. The co-payment was taken upfront, and I waited about another 10 minutes to be seen by a medical assistant.
She took my information on a tablet PC, took my vitals, and left me to wait for not long enough to crack a magazine. When my doctor arrived she also had a tablet PC which she synched with a docking station, asked me a few more questions to make sure she had the right patient, and flashed a light down my throat (“It’s really swollen”).
She punched a few buttons on the screen with her stylus and told me she’d faxed the prescription to my choice of local pharmacy. If anyone else in my family came down with the same thing, just come in and ask for the prescription, she said “You don’t need to go through all of this.”
Out of the house at 1033AM, home by 1150AM. Total time = 77 minutes. Value added time = 8 minutes (face time with medical assistant + face time with doctor + face time with pharmacist). Ten point three eight percent value added. Not at all bad, considering the weekend was a total loss. Prevention is still the best healthcare solution.

  1. robert thompson

    April 10, 2007 - 2:06 am

    Here in the UK our National Health Service (NHS) is in a bad way (http://tinyurl.com/2cqeff):
    “Many hospital stays ‘waste money’: Shortening hospital stays could help cut waiting times. Keeping NHS patients in hospital too long takes up the equivalent of 13,000 beds a year and costs £1bn, a think tank has estimated.”
    However, Lean techniques are just being introduced (http://tinyurl.com/25m689) using the following principles:
    . Who are our customers? Simply the patient? Who is the customer for public health?
    . What is the demand that hits our system? The variety, volume and complexity of demand in the NHS all exceed those encountered in the manufacturing / private service sectors. This makes the task of understanding demands much harder.
    . What does value mean for the NHS? This must be first and foremost health; the perception that in service industries the consumer is a co-producer of value is a helpful one. Conversely identifying failure demand in the context of human mortality and imperfect medical science is indeed challenging.
    How successful this will be remains to be seen, my personal experience in A&E is far worse than yours Jon.

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