Lean in healthcare and cultural change

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It suggests the existence of a healthcare organization Lean culture proficiency archetype and introduces the notion of Lean cultural friction. The authors would like to thank Dr Nicky Shaw for her insightful comments on work-in-progress versions of this manuscript. Dorval, M. Report bugs here. Please share your general feedback.

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Jeffrey Liker. David Mann. Gerard A. Review People want to be part of a larger vision and purpose and they want to be involved. Everyone wants to contribute their skills and abilities and be productive. We just have to lead and structure the organization in such a way that gives them the chance to do so. Nothing is more important to their success or your organization and Lean Culture Change gives you a way to actually do it. Lean Culture Change explains the first steps in that plan.

In order to accomplish this, there must be a core leadership structure, strategic vision and system to support them. Leuschel and Lewis lead you on a journey in Lean Culture Change to the roots of building this structure and support.

Find your True North! I encourage readers to understand the purposes of each of the components of Daily Management that Steve describes and how the components fit together to create a practical and sustainable foundation for continuous improvement. Every healthcare organization should pay attention to this message. These are all very important. However without the how - the needed execution to achieve - high performance will not take place. Lean Culture Change does a superb job putting all the ingredients together.

By following the processes outlined, the reader will improve their own skill set and the organization's performance. Quint Studer. Brief content visible, double tap to read full content. Full content visible, double tap to read brief content. Help others learn more about this product by uploading a video! About the author Follow authors to get new release updates, plus improved recommendations.

Steven R Leuschel. Read more Read less. Customer reviews. How customer reviews and ratings work Customer Reviews, including Product Star Ratings help customers to learn more about the product and decide whether it is the right product for them. Learn more how customers reviews work on Amazon. Top reviews Most recent Top reviews. Top reviews from the United States.

There was a problem filtering reviews right now. Please try again later. Verified Purchase. As a lean professional working for a hospital and a PhD who never grew out of accumulating literature in my field , I probably own every book ever published on Lean Healthcare. Not all are created equal, but this practical how-to by Steve Leuschel full of short illustrative case studies is one I keep coming back to.

Now as more and more hospitals are developing more mature cultures, they are finding a desperate need to sustain the improvements they have learned how to make. Leuschel's book is more than just a "here's how we did it it at my hospital" - with a foreward from Mike Hoseus and an introduction by Rodger Lewis, this is based on a solid model derived from Toyota and implemented effectively in a PA hospital.

The combination of a model, a set of daily management tools, and lots of visual examples reminds me of one of my other favorite books as a lean practitioner: Mike Rother's Toyota Kata. My hospital is just now embarking on an effort to start a daily management system, and Lean Culture Change is one of my most marked-up reference manuals.

One person found this helpful. Steve Leuschel brings experience, wisdom, and heart to the Lean movement.

Curious technological changes in healthcare pros and cons are

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In the end, terms like Lean, Six Sigma, and other labels that get attached to quality-improvement concepts are less important than the concepts and strategies they represent. These concepts and strategies have been tested and proven in countless industries. In healthcare, they have tremendous potential to help organizations keep patients safe and satisfied, support and inspire staff at all levels, and sustain their success for the long term. Those questions come from the right motivation.

But Lean healthcare is not about cutting costs. As mentioned above, Lean is about putting the patient first. A Lean management system encompasses a range of big-picture characteristics and day-to-day practices, which take time to fully implement.

At a high level, we can define a Lean organization by a handful of core activities and principles:. In healthcare, success is defined by patient outcomes and experience. For example, a team might explore the steps their patients go through each time they come in to see a provider. This helps the team identify and remove roadblocks for patients, such as:. A patient who completes paperwork at home may be more likely to arrive on time, which helps all patients receive the timely care they expect.

The patient may also be more thorough and accurate when entering information about current medications, which helps providers make informed treatment decisions and avoid harmful drug interactions. Lean management mobilizes the entire workforce to improve the work that matters most to the organization.

Leaders set clear goals, while teams and even individual team members adopt their own targets that support those goals. A Lean healthcare organization provides the structure and culture that workers need to sustain quality and safety as part of their daily work. How can one team affect quality throughout an organization? And what happens when the initiative is done? Constant improvement is possible only when frontline workers are empowered to lead it.

A central tenet of Lean is respecting the expertise of the individuals who do the work. Leaders show respect by stepping away from the role of problem- solver and instead take on the role of problem- framer.

In healthcare, this means leaders:. In the role of problem framers, leaders give frontline team members the time and tools to find inefficiencies and then devise and implement new, more effective methods.

Ultimately, the entire team is engaged and valued, and both patient care and team satisfaction improve. A key habit in the practice of constant improvement is root cause analysis: going beyond factors on the surface to find the true source of a problem. Root causes are often mundane, such as where equipment is stored or how samples are labeled. But these mundane factors can lead to annoying or even harmful outcomes and errors.

So adjusting them can make work significantly safer and more efficient. Seeking root causes is another way of showing respect for workers.

Rather than blame the person who made a mistake, leaders partner with the person to explore why the error was made. What conditions allowed the mistake to occur? How can we change them to prevent future mistakes and promote the safe, high-quality actions we want? By focusing on why the process — and not the person — may be flawed, leaders cultivate an environment where frontline staff are more eager and willing to speak up and share their ideas for improvement.

Patient care is inherently dynamic. This proves that the willingness to try new solutions is even more important than the initial impulse to improve. With quality improvement, strategic alignment, staff empowerment and other core competencies baked into their DNA and daily operation, Lean organizations have the tools and mindset to iterate, flex, evolve and innovate.

A patient-centered system can be a powerful management method for healthcare organizations. Koenigsaecker has led 11 corporations, including Jacobs Vehicle Equipment and Danaher, through Lean transformations and serves as an advisor and Board member for Simpler Healthcare and Simpler Consulting.

In his presentation, Koenigsaecker emphasized the role of leadership in implementing Lean, pointing out that Lean requires adults to learn new attitudes and behaviors—a far more sustained and challenging leadership effort than getting everyone on board with new technology and processes.

Success with Lean takes time and involves culture change. That is always challenging, but traditional Lean teaching, beginning with Toyota, did not include leadership training of the sort that interests us today. TPS was taught and fostered through mentorship, without documented leadership principles. Koenigsaecker reports that Taiichi Ohno did all of what we now call change management at Toyota singlehandedly.

The lack of delegation and documentation created a blind spot in future training and, ultimately, an opportunity for Koenigsaecker:. What are the leadership issues in making this happen?

What are the problems you run into? What kind of changes do you need to make in terms of leadership style, approach, and activities to be successful? That was missing from the education I got from my master sensei.

Over the years, I began to realize, maybe I can make a contribution in that regard. Describing that culture change, Koenigsaecker said that Lean can become a way of thinking, even a way of life.

He offered the following progression of Lean learning, used in an organization not healthcare-related that has been working on Lean transformation for many years. The learning happens gradually through five phases, which can take at least 6 to 10 years to accomplish in an organization:. Perhaps we should also be talking about patient safety transformation. The lack of delegation and documentation created a blind spot in future training and, ultimately, an opportunity for Koenigsaecker: What are the leadership issues in making this happen?