Born in the 1950’s out of Toyota manufacturing plants, Lean methodology has been effectively leveraged to create greater efficiencies in manufacturing ever since. It wasn’t until a half-century later that healthcare facilities in the United States, Europe, and Australia began to apply the same principles to patient care. Ever since, interest in applying Lean in healthcare has grown rapidly.
Why Lean Makes Sense in Healthcare
The five Lean principles include Defining Value, Mapping the Value Stream, Creating Flow, Establishing Pull, and Pursuing Perfection. By achieving success in the first four principles, waste is prevented. When all five Lean principles are adhered to, a framework is established to create efficiency. Whether applying the methodology to the manufacturing of automobiles or the treating of patients, all that adhere to these principles benefit by discovering inefficiencies in their organization, addressing those inefficiencies, and providing greater value to their customers.
When Lean is effectively applied in healthcare, the result for the patient is better quality of care and a better experience. For those providing the treatment, greater productivity is generated with existing resources. Additionally, staff satisfaction improves due to reduced stress.
In the clinic setting, patient flow and the work required to manage it must be visible to all team members. Today, clinics are heavily reliant upon EHR’s for management of patient flow. Visibility into patient flow is lost when relying on an EHR. Patient data is segregated in EHR’s. It is not possible to know what the right next step is for each patient’s visit. When delays occur, there is no easy way to identify and address the issues when workflow is buried in the computer.
SyncTimes: Lean Patient Flow
SyncTimes employs Lean methodology to provide for real-time communication and visibility into patient flow. The first of the five Lean principles, defining value, is step one when SyncTimes engages with a health center. The SyncTimes team identifies where value exists to patients in the current flow and considers the patient perspective. In addition to providing an effective diagnosis and treatment, how patients spend their time in the clinic is critical in forming the value of a visit.
SyncTimes works with partner health centers to Map the Value Stream and identify waste. Activities that do not add value to the patient are considered waste. Waste then must be categorized as non-value added but necessary and non-value added and unnecessary. By reducing unnecessary processes or steps, patient and staff satisfaction improve. Poor communication increases non-value added time, diminishing the overall value of the patient experience.
Adhering to the third principle, SyncTimes works with care teams to ensure that there is an understanding of the value of improving communication. While any change is hard, we often find that improved flow is achieved shortly after implementation. Teams soon customize SyncTimes workflows to better support their patient flow. Overall, the system makes patient flow improvements possible, often in spite of challenging floor plans and disruptions to patient care.
When Establishing Pull, the fourth principle, the goal is to limit work in process (WIP) items while ensuring that the necessary information is available for smooth patient flow. Together with the partner health center, SyncTimes helps implement just-in-time delivery. Once implemented, while the provider is still with the patient, she enters the care plan for her patient. In real time, the care plan is shared with the care team so that they may prepare to carry out the plan while the provider is still with the patient. SyncTimes eliminates the time wasted searching through an EMR to identify if a care plan has been added and tracking down the team to verbally communicate the plan.
When the first four Lean principles are adhered to, it becomes the objective of the clinic to achieve principle five: Pursue Perfection. Robust reporting on cycle times, provider productivity, scheduling efficiency, exam room utilization, and more is made available in the solution. By setting goals and making data-driven decisions, all team members can work together to pursue perfection.
By identifying value, mapping patient flow, creating flow and adopting a pull, the care teams are prepared to eliminate waste as communication is improved, visibility of flow is accessible across multiple screens on the floor, and eliminated is the search for other members of the care team to seek assistance or communicate care plans. With the SyncTimes solution in place, our partner health centers have reduced cycle times by 6% and reduced patient alone time by 12% within one year of implementation. The elimination of waste is evident and the pursuit of perfection continues.
Lean certainly has a home in healthcare. When strategies are implemented adhering to its principles and the pursuit of perfection is ongoing, value is added to the patient and caregivers. Lean health centers provide better patient care with less, improving their communities one patient at a time.