Kaizen

Hospitals across the country are challenged more than ever to reduce costs without sacrificing quality of care. While the success of others can offer a guide, the true solutions for your challenges already live inside your hospital.
Today, many hospitals are lowering costs, increasing efficiency and improving quality by applying the same methodologies that advanced the famous Toyota Production System. At Toyota, their continual improvements (Kaizen) added up to major benefits: faster delivery, lower costs and greater customer satisfaction. In the same manner, the use of lean methodologies like Kaizen has made clinical operations more reliable and less wasteful while encouraging legitimate and meaningful employee involvement.
Singapore's Alexandra Hospital, for instance, spent a year using the Toyota "thinking people system" to streamline and improve quality; they were able to reduce patient waiting time by 50 percent, realize a 400 percent increase in productivity and lower health screening costs to $10 per patient. Likewise, in my own experience at Sheridan, clinical Kaizen initiatives have successfully reduced operating room (OR) start delays and case cancellations, which cost hospitals millions of dollars each year, as noted by a study presented at the American Society of Anesthesiologists' annual conference.
Here are six key Kaizen principles that hospital leaders can use to take their clinical operations to the next level.
The seven deadly wastes: Look for improvement in wasted movement, corrections, overproduction, waiting, excess inventory, processing parts and transporting parts and materials.
Everyone is integral: Seek the wisdom of 10, not the wisdom of one. People at all levels of an organization must be empowered to improve productivity and quality in their own individual work environments.
Understand the process: Kaizen requires a strategy and a clear vision. Answering some fundamental questions about the nature of your organization can help your Kaizen team locate its mission: What is the value proposition of the company? By what means and principles will that vision be obtained? How is success toward that purpose measured?
Time, space and concurrent sequence: To better understand what is occurring in a given process, the three perspectives of time, space and concurrent sequence should be analyzed to discover improvement opportunities. These multiple perspectives help to paint visible solutions to "impossible" problems.
Devote the resources: To attain true Lean transformation, the type thriving in both industrial and clinical settings, Kaizen needs to be done as a long-term project with the help of an expert Kaizen facilitator and the support of the entire medical staff. And as noted by The Advisory Board, 90 percent of all improvement initiatives are either wholly or partially dependent on physicians making them happen. Therefore, physician involvement, in particular, is a key factor that influences a protocol's clinical acceptance and long-term sustainability. Due to this, hospital leaders cannot solve such challenges without a strong process improvement culture and even stronger physician partnerships.
Measure for measure: Solutions have to be measurable. Tangible results include higher quality, lower cost, reduced cycle times, improved safety, and more efficient use of resources. To delineate a clear before and after, measure outcomes by outlining information about the facility pre-Kaizen, the factors that led up to the Kaizen, the people selected for the team, observations made during the process, and the comparison of the problem pre-Kaizen and post-Kaizen.
Whether trying to combat low case volume, lower costs or improve efficiency, hospital leaders and physicians who establish quality as priority and who work in a performance-driven culture have the greatest ability to organize the resources necessary to support ongoing Lean transformation. Only then can hospitals significantly differentiate themselves from their competition, optimize efficiency, and continuously locate opportunities to reduce costs.