Hospitals Turn To Unlikely Source To Improve Patient Care
By Christine Kern, contributing writer
The Toyota Lean Model proves effective in improving efficiency in healthcare.
According to the Lean Enterprise Institute, the premise of lean manufacturing is to produce an item based on customer specifications in the fastest, most efficient way, and for the best possible price while maximizing customer value while minimizing waste. Earlier this year, researchers at Penn State Hershey Children’s Hospital conducted a study applying lean technology to streamline healthcare and reduce the numbers of patients that must be turned away, as Health IT Outcomes reported.
A number of private hospitals in Wisconsin, Denver, and Seattle have been applying Toyota’s lean principles for years in order to streamline operations, reduce costs, and improve patient care and safety. Denver Health is one such health system with a “no-layoffs philosophy,” having saved over $150 million through their Lean program. Without those savings, Denver Health would “absolutely have had to cut jobs,” said CEO Patricia Gabow, MD, in a Denver Post report.
Now, with greater pressure to improve outcomes and reduce costs as a result of the ACA, the California HealthCare Foundation has funded a project at Harbor-UCLA and four San Francisco Bay Area Hospitals using Toyota’s system, according to Kaiser Health News.
Not all healthcare employees are sold on the lean approach. As DeAnn McEwen, a health and safety specialist with National Nurses United told Kaiser Health News, the Toyota system reduces nursing to a series of standardized tasks, treating nurses like robots. “The problem with that is patients, of course, are not widgets and nurses are not robots. And nursing care is not a commodity but a service. It’s a process that requires critical thinking and the application of judgement.”
While some are skeptical about applying approaches from manufacturing to healthcare, it does seem to be making a difference. Kelly Pfiefer, director of high-value care at the California HealthCare Foundation, asserts that Toyota’s techniques have proven effective. The Foundation helped provide funding for the lean project at Harbor-UCLA, San Francisco General Hospital, Contra Costa Regional Medical Center, San Mateo Medical Center, and the Alameda Health Center.
One key to applying the lean approach is in organization of equipment rooms and supply cabinets, one area where Toshi Kitamura, a Toyota advisor, explained that there are natural parallels between patient care and automotive production. “There was a clear translation,” he told Kaiser Health News. “Just as in the hospital environment, in our environment we need to make sure we have all the tools and materials we need and we need to be able to find them quickly.”
As a result of implementing the lean principles, the project has seen reduction in hospital stays and decreasing medication errors, and large cost savings, with San Mateo Medical Center experiencing almost half a million dollars in savings as a result of reducing surgery cancellations.
And at Harbor-UCLA’s outpatient eye clinic, the average number of new patients seen daily has doubled, while the time patients spend in-clinic has be halved. Surgeries are also being scheduled more quickly.