There's a tremendous amount of waste occurring in the
healthcare industry. In order to address that waste, organizations are moving
to lean management because it exposes what and where these wastes are and
rethinks the way work is done via value streams.
Most providers are set up by departments, or vertical silos.
In the case of manufacturing, it's products that traverse these departments,
from receiving an order to collecting the money for it. In healthcare, what
traverses departments are the patients.
Tracking patients horizontally through a healthcare value
stream changes the way you think about what's value-added and what's not said
Marc Hafer, author of the book Simpler Healthcare and CEO of Simpler, a firm
globally dedicated to lean application, techniques and transformation in
healthcare. "When you reconstruct patient flow through an experience at a
clinic and you think horizontally... that's when you see all the waste there
really is," he said.
Hafer shared with Healthcare Finance News the eight
different types of waste that inhibit patient flow, add cost, increase poor
quality and infection and decrease patient and clinician satisfaction.
"When you remove waste, all these things change for the better,"
remarked Hafer. "The value-added stream method is fundamental for patient
flow in healthcare organizations."
1. Transportation
Transportation is entirely non-value-added. "It
contributes nothing to patient care. It adds to delays and increases likelihood
there will be defects and dissatisfaction," Hafer said. Transportation
includes moving patients from one department to the next, shifting supplies and
equipment and moving instruments from sterile processing areas to the OR and
back again – and even when patients travel to and from the actual hospital
itself.
2. Inventory
Inventory can include pharmaceuticals, supplies, and
patients, too, if you consider a waiting room in a hospital. The replenishment
system should be based on use as opposed to some forecast. "Only what's
needed when it's needed is a good approach with inventory," Hafer said.
3. Unnecessary motions
Reaching, bending, twisting, turning. These motions are all
ergonomic issues abundant within healthcare. Clinicians are injured because
processes like transporting a patient from wheelchairs to beds aren't designed
ergonomically. Staff takes time off for rehabilitation when unnecessary motions
incapacitate them, which can result in a loss of productivity and enhance
overall costs.
4. Waiting
"Patients waiting for treatments, clinicians waiting
for supplies... as cliche as it sounds, time is money," said Hafer. And
sometimes it's a matter of safety, too. There are some medications that need to
be administered within a certain amount of time
after a reaction or a procedure. Waiting can diminish the quality of the
pharmaceutical and it's effectiveness with the patient.
5. Overproducing
Overproducing is creating more of something than what's
exactly needed. Sending medications to a patient's room that won't be used
because the patient has already been discharged is an example. Along the same
vein, this type of miscommunication between departments can also extend a
patient's stay which is another form of overproduction. Other examples include
repetition of diagnostic tests and the multiple registrations a patient has to
endure when checking in. It's a laborious, unnecessary process and one time
should be sufficient enough.
6. Processing Waste
Creating reports that don't get read or aren't useful, administering
duplicate tests – doing things where you produce 105 percent when you only needed to give 100 percent is
processing waste, Hafer explained.
7. Defects
There are countless defects within healthcare situations,
such as hospital-acquired infections, early discharges that lead to
readmissions, incomplete medical records or instrument kits in the ER and
inaccurate medical billing. In many circumstances, these defects are covered-up
through reworks and work-arounds, Hafer said, but with lean management, a light
is shed on these defects, the root cause is figured out and a countermeasure is
put in place that won't allow them to reoccur.
8. Unused human potential
With all the waste that already exists in healthcare, the
last thing clinicians need to do is more non-value-added work, Hafer said, yet
it happens all the time. Lean organizations involve people in redesigning work
and real-time problem solving, Hafer explained, unleashing human talent on the
right things to solve problems and reduce waste for patients.
Source: healthcarefinancenews
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