Lean healthcare around the world
Planet Lean: What is the Lean Healthcare Initiative and what is its work focused on?
Flávio Battaglia: In 2015, the Lean Global Network created a healthcare initiative to try to compile our knowledge of lean healthcare and improve the way we support the industry. We began working together both remotely and physically, visiting one another's gemba several times. We realized that, at the current pace, the transformation of the entire healthcare sector would take more than a century, so we started looking for the key success factors that could help organizations accelerate and sustain their lean transformations. We studied several cases, made comparisons and, finally, arrived at five elements that we found to be common to all of these experiences. With these five guidelines, we believe lean transformations in healthcare can be faster and easier to sustain.
PL: What are the five principles?
FB: The first – “Don't wait for the CEO” – concerns the need not to depend on top-level leaders to start the change or keep it going.
The second – “What is your next step and why?” – is about analyzing your next step in the transformation, usually by addressing a pressing business issue. More generally, the second principle speaks to the need to always keep an eye on the future: what is the next step in the process? What does the patient need next?
The third principle – “Own the problem” – encourages area managers and frontline staff to truly acknowledge the problem they have identified and take responsibility for solving it. Lean is a team sport! In other words, this creates a sense of ownership.
The fourth principle – “The right knowledge for the right people at the right time” – reminds us that comprehensive training is not a solution to your people development needs. It is important that we do not give people so much information that they become overwhelmed.
The fifth principle – cross-pollination – refers to the important idea of yokoten (or knowledge sharing) and explains how powerful it can be in a lean transformation.
We at the Lean Healthcare Initiative (LHI) have internalized these principles and are actively using them in our coaching activities. Healthcare organizations are equally enthusiastic: every time we show them the principles, they tell us they see themselves reflected in them.
PL: What is the LHI's contribution to the upcoming Lean Global Connection?
FB: For our main-stage presentation, we will explore each of the five principles in depth. We will have five coaches from our team (myself, Alice Lee, Oriol Cuatrecasas, Denise Bennett and Vyacheslav Boltrukevich) and five practitioners (Carlos Frederico Pinto, Javier Sala, Olga Farré, David Plunkett and Kiame Mahaniah), representing six countries. Each principle will be discussed by two practitioners.
We are also organizing some premium presentations. We will have Dr. Fred discussing the extended value stream for cancer patients that he applies in the municipality of São José dos Campos. Another presentation will focus on a national lean program for Brazilian emergency departments, and in a third, Dr. Fred and the IHI will share their experience developing a leadership program to reduce ICU infections using TWI. We will also have cases from Argentina, the Netherlands, Turkey, China and Spain. It's going to be a great event!
PL: How has being part of the Lean Global Network (LGN) made you a better lean coach?
FB: What unites us at the LGN is our common sense of purpose, both as individuals and as institutes. It is our DNA. Events like the LGC help us get to know each other better. Over the years, we have found it extremely useful to learn from one another, and we have grown a lot by examining our different perspectives. Although we often have different ways of working, at the LGN we are more alike than we think. It is our sense of purpose that unites us. The mission of spreading lean thinking and practice is in our DNA.
