Operational Excellence Strategy for Medical Organizations

Healthcare is a ripe area for operational improvement.  The economy has put pressure on hospitals and clinics because their systems cannot sustain the rise in costs, nor can consumers and allied healthcare plans bear many more increases in costs.

Lean Six Sigma (LSS) and Op Ex sponsors and associated project leaders have fertile ground here:  There is a lot of room for eliminating waste, for improving process flow, and even increasing revenues for health organizations by virtue of increased patient flow.

At the same time, it’s critical to maintain safety, and there can be no jeopardy to the quality of healthcare. Therefore, before starting your LSS or Op Ex journey, you will have to put a few basics in place.  Ensure change has sanction from the top.  The senior executive class must not only buy in, but they must actively support change and its destination on an ongoing basis.  Hire consultants who will begin the process by teaching basic change management, with subsequent implementation of Lean Six Sigma or Op Ex tools and metrics.  Once you’ve identified the appropriate areas and processes for improvement, hand pick the first group of employees to train for the new process.  This involves formal as well as informal leaders in the organization – those individuals that other people want to follow, not just those they feel they have to follow.

Make improvements to “low hanging fruit” early on – that is, accumulate some easy successes, and tout those to everyone in the organization.  Success begets success.  Build on this and establish a solid process for choosing which projects to take on (those that have merit), how many, and in what order of prioritization.  Then, make the commitment to continuous process improvement.

Throughout, be certain to maintain care for the “people” factor.  The medical field is intensely people focused – more so than almost any other field imaginable. You cannot afford to focus solely on the technical/process side:  Be mindful of the stress change brings with it and observe carefully those who are lagging or hindering progress.

In a nice real-world example, we can consider “XYZ HealthCare” and visits to physicians.  They typically involve a significant amount of wasted time:  You invariably read a magazine for some period of time before you’re called to the examination room. You wait. A nurse records your weight, vital signs, history, and some other questions.  She departs and you wait again.  Eventually, the doctor arrives, reviews the data and asks more questions, sometimes duplicating the nurse’s, and finally gets around to the examination for which you came to the office.

Generally speaking, the wait and waste is due to lack of process survey.  Once you take the time to examine process, invariably you will note areas for measure and subsequent improvement:  By timing patients’ stops at each point in the process, from reception area to exam, we can assess the cause of lags.  We can examine whether standard, and best, practices are being followed by each staff person, nurse, and doctor in the process, and target areas for improvement.  Do receptionists have ready access to data at their workstation, or do they have to walk somewhere to retrieve it?  How far?  Is the dispersion and various harbor of data necessary, or can it be consolidated to a more efficient process?

Are exam rooms standardized?  Are they stocked the same, or even completely?  Measure how often personnel have to leave an exam room to get something necessary and then determine if there’s some consistency that would support a change to the room’s standard stock.

Each healthcare organization will have its own unique variables, constants, and problems.  The idea here is to survey and identify prospective areas and procedures for improvements in accordance with LSS/Op Ex measures and initiatives to the specific organization.

In the case of XYZ HealthCare, they were able to reduce patient wait time by 25%, and add 20% more patient volume.  There also was a respective improvement to customer satisfaction and increased revenue for the clinic. Each improvement made achieved the results LSS and Op Ex were designed to do: increase the bottom line and the people involved in the process – from clinician to customer.

About the AuthorSheree Lavelle, MS, is a Six Sigma Black Belt and earned her certification in Lean by successfully completing the Global Production System Japan Gembe Kaizen program in Japan. Sheree has more than 20 years of experience as an Operational Manager in both clinic and hospital settings. Currently, she is president of Lavelle and Associates, LLC, a consulting firm specializing in Lean Six Sigma Process Improvement. For more information or to contact Sheree in person, visit her website at http://lavelleandassociatesllc.com.


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