The lean thinking method is used to reduce waste while organizing processes that are complex to encourage production. There has been increasing interest to apply the principles of lean thinking in healthcare rather than letting it remain in the manufacturing sector for which it was initially created. Healthcare institutions that use this method are those that focus on time imperative, complex care.
Lean thinking was originally created as a production idea and quality system with both elements of mass production and craft production (Joosten, Bongers, & Janssen, 2009). With its emphasis on standardization, lean thinking attempts to minimize inventory and get better processes. It minimizes the time between the time when a customer requests for a product and when he gets it. Lean thinking created a set of tools that were first applied at the Toyota Corporation and were utilized later in manufacturing, automotive and service industries before eventually being introduced to healthcare.
Lean thinking has changed considerably since its inception. First, lean thinking originated from Toyota Corporation to other automobile manufacturing plants. It was later to be adopted by other manufacturers in the second stage. Since automobile manufacturers are relatively similar, there was no need to alter the instruments that were used in the original process. It was initially limited to the use of shop floor tools.
With time, the method evolved from the application of these tools. The five principles of lean thinking that were introduced by Womack and Jones (2003) helped to speed up the evolution process. Their introduction put waste reduction and customer service at the center of lean thinking. They also served to fuel the dispute that customer value and processes came at the cost of the working circumstances of the employees. The five principles introduced include: providing customer desired values, identification of the value strain while eliminating wastage, lining up the rest of the steps such that continuous flow is created, production is pulled to be in harmony with customer consumption and finally, the process is started over in pursuit of perfection seeking to achieve the zero wastage model.
While the use of the original lean thinking tools remains widespread, the method’s application has extended from the initial simply operational aspect to a vaster aspect that includes behavioral aspects and the boundary between the two. The current lean thinking systems largely incorporate both a quality system and a quality culture.
As in all other industries, lean thinking should be targeted at improving production and reducing wastage in health care. It should therefore lead to the creation of an efficient system that leads to minimal wastage in terms of unnecessary administrative costs and activities as well as maximizes the use of available resources. According to Ahene (2007) the challenge of those trying to implement the lean thinking system into health care ought to revolutionalize their expectations of health care. They also need to create a system that facilitates for the continuous work flow for clinicians and a flawless patient care experience. By so doing, an institution will be able to reduce the rate of wastage within an institution hence making it worthwhile to compete in terms of productivity and quality care.
The support by top leadership both at national and organizational levels is vital for the implementation of lean health care. Senior nurses who are on the ground are the best people to adopt such a system since they are the people closest to patients. They are also in constant contact with patients and hence best able to ensure prompt delivery of the much required services.
The strategic purpose of any organization should therefore be to empower senior nurses in the organization and ensure that they have sufficient knowledge and expertise to implement the system. Training and education should be measured using ‘belt’ levels. These are health competency standards that are universally accepted. Yellow belts acknowledge basic understanding; green belts acknowledge possession of sufficient knowledge to implement lean practices and tools while black belt signifies passion of such knowledge as may be required in the implementation of projects that are likely to produce significant savings in funds. To ensure that the lean system is implemented and maintained successfully, senior nurses should at least be trained to nurse levels.
An organization should be dedicated to develop dedicated improvement expertise and internal capability that is developed to create a culture that concentrates on working with systems (Weberg, 2012). This type of mentality is vital for continuous improvements. One important step is to select a lead facilitator who is appointed to co-ordinate education, key staff from within the entire organization across all core healthcare processes. This should be done until all key staff develops appreciation for the lean tools and practices. An organization should then select a small number of lean champions who will help drive the processes of the lean system with the backing of their colleagues.
Challenges of lean thinking
The biggest challenge the lean system experiences is the fact that it takes a lot of effort to implement the system. This is especially since the organization must promote the system to the personnel making the workforce aware of the potential benefits so as to gain their approval and support.
In some countries, there also exists a challenge of getting approval from the government and the NHS. These two groups are vital and must approve the implementation of the system for it to be effected. If approved, the rest is much easier for those hospitals that intend to implement it.
Benefits of lean healthcare
Lean healthcare has a series of benefits for all the shareholders of the industry. It is responsible for shorter waiting times for patients as the systems are primed to bring forth the highest level of production. This process minimizes time wastage hence providing more delivery time for patients. The process is also to blame for more patient admissions and diagnoses and quicker bed turn arounds. Due to the effectiveness of the system, it leads to improved workplace organization, safety and organization. The patient record becomes more reliable, there is more timely care delivery and better storage and supply management.
In conclusion, lean
thinking helps to improve the performance of any industry by eliminating wasteful
processes. It also maximizes the effort of the work force hence improving productivity.
It has only recently been adopted into healthcare. The implementation of this
system into any institution requires the input of all shareholders. The process
must be approved by the government and its agencies and must also be accepted
by the workers. It therefore takes a lot of time to implement but goes smoothly
soon after training. The benefits are vast and revolve around delivery and
optimization of the effort put by workers.
Aherne, J. (2007). Think lean. (cover story). Nursing Management – UK, 13(10), 13-15.
Joosten, T., Bongers, I., & Janssen, R. (2009). Application of lean thinking to health care: issues and observations. International Journal for Quality in Health Care, 21(5), 341-347.
Weberg, D. (2012). Complexity Leadership: A Healthcare Imperative. Nursing Forum, 47(4), 268-277. doi:10.1111/j.1744-6198.2012.00276.x
Womack, J. P., & Jones, D. T. (2003). Lean thinking: banish waste and create wealth in your corporation. Simon and Schuster.
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