Lean {People + Process + Technology} = Improved Outcomes

Lean {People + Process + Technology} = Improved Outcomes

he health care in U.S is in a state of crisis, with increasing costs, poor access, health inequality, decreasing reimbursements, and significant preventable harm done to the patients. According to a recent article, it is estimated that the health care costs in U.S were $3.2 trillion in 2015 which is equivalent to 17.8% of GDP. Even though U.S is one of the highest spending nations in the world, in many respects, the system is not the most efficient and effective in delivering desired outcomes.

There is a lot of emphasis on improving the health care delivery system and reducing costs over the last decade with several programs like Hospital Value-Based Purchasing Program, Readmissions Reduction Program, Hospital-Acquired Condition Reduction Program, Bundled Payments for Care Improvement Initiative, Comprehensive Primary Care Initiative (CPC), Accountable Care Organizations (ACO) models, Quality Payment Program (QPP), etc.

Healthcare organizations are investing significant resources in performing well under these different programs and improving the outcomes. Despite these large investments, outcomes appear to be not improving at the desired rate with costs continue to climb.

For the healthcare organizations to be successful in performing well under these different programs, there are three primary areas of focus that need to be looked from a Lean perspective.

1) People

Healthcare organizations are facing severe challenges – work overload, lack of enough staff, poor organizational culture, Lack of mentoring, etc. Many of the frontline staff are usually unaware of organization’s strategic goals and how their work/role is helping to achieve these goals. For complex organizations, such as ACOs and health systems, to succeed at addressing the extent of challenges facing them, they need to be able to effectively align the priorities throughout the organization.

Adopting a lean philosophy helps to develop leaders in the organization and solve complex problems in this ever-changing healthcare environment. This focus on developing people enables continuous improvement and integration with the process and technology components.

A system-wide hoshin kanri planning or balanced scorecard approach needs to be adopted to translate organization’s vision and strategy to the initiatives and projects that need to be planned across the organization. This creates an organizational alignment with focused priorities that would also develop the people in the organization.

2) Process

A series of actions or steps taken to achieve an outcome is the fundamental definition of process. We have millions of processes in our organizations which might be different from one to another. It is important to start focusing on improving processes than hoping for better outcomes. A Lean program needs to be deployed with a goal to create a patient-centered, data-driven, team-based, continuously improving organizational performance improvement culture. This helps organizations to get closer to becoming highly reliable by developing Robust Process Improvement (RPI) capabilities.

Lean deployment requires focused, aligned, long‐term thinking, and a significant cultural change that only a few organizations will achieve.

As described in the table below, a simple assessment around methods, training, and spread can help organizations to monitor their progress around performance improvement in the organization.

3) Technology

Investment in technology is becoming a substantial driver in the increasing costs of healthcare. However, the actual impact of technology on the outcomes is usually less than expected. The disconnect between the potential impact of technology and the anticipated benefits has less to do with the actual technology than the approach and process taken to understand the problem that is being solved and then deploying and supporting the technology through continuous PDCA problem-solving. This approach results in the integration with current processes and people (staff, providers, patients, etc.) using the technology, and enables a culture of continuous improvement.

Healthcare technology is rapidly advancing and will continue to evolve. Organizations that understand this and deploy it are going to be very successful, while organizations that do not find an effective way to deploy them are going to have a limited or negative effect.

In conclusion, focusing on people, processes, and technology from a Lean perspective are going to accelerate the achievement of outcomes in healthcare organizations.

  • People – Aligning the strategic goals and developing individuals in the organization through team problem-solving, building mutual trust, and respect.
  • Process – Striving for defect free, zero-waste processes through the management of Key Performance Indicators (KPIs), experimentation, and standard work.
  • Technology – Integrating Lean/PDCA into the selection and deployment of technology to unlock the anticipated benefits of evolving healthcare technology.

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