SHARINGEXCELLENCEWhat Healthcare is Learning from Manufacturing
• Retained Executive Search Firm Specializing in TPS and Transformational Operating Systems
• Exclusive focus since 1991
INTRODUCTION
• USA richest country in the world yet lagging in healthcare.
• WHO ranks US 37th vs. all other nations.
(blended ranking combines health of citizens, cost of care, responsiveness of health system)
SPENDING MORE FOR LESS
SPENDING MORE FOR LESS
Source: OECD
SPENDING MORE FOR LESS
VIEW FROM THE HOSPITAL LEVEL
• Patient volumes in decline – Higher deductible rates– unemployment/uninsured– Elective procedures down
• Revenue (reimbursement rates) in decline– Medicare– Medicaid– Private insurance
OPERATING REVENUE IN DECLINE
$
• Medical errors kill enough people each week to fill four jumbo jets
• 25% of patients are harmed through medical errors
• Standard methods used to detect errors fail as much as 90% of the time
• Reimbursement increasingly tied to quality metrics
Sources: WSJ 9/21/12; US News and World Report 8/28/12;
QUALITY ISSUES
2009
• $210 Billion: Unneeded services
• $190 billion: Excess administrative costs
• $130 billion: Mistakes and delivery inefficiencies
(preventable complications, fragmented
care).• $105 billion: Artificially
high prices.
Source: Institute of Medicine report 9/12
WASTE ABOUNDS
• Topline Revenue in decline• Quality issues alarmingly
high• Unsustainable levels of waste
• Increased levels of accountability
LEAN/TPS
SUMMARY
LEAN AND THE HEALTHCARE INDUSTRY
• 10 years ago less than 3% of hospitals were investigating Lean.
• Today that number is closer to 30% and growing.
• Stiles Associates Healthcare practice has grown 10x in 5 Years.
GROWING DEMAND FOR LEAN
• Consultants • Internal Lean Teams• Cross Industry Collaboration:
– ThedaCare - Ariens– Virginia Mason – Toyota– WellSpan and GM build simulation training
center– Autoliv tours– Many more
HOSPITAL SOURCES FOR LEAN
• Emergency Departments• Operating Rooms (scheduling/set up/turnover)• Inpatient units • Materials/Supply Chain• Labs• Discharge process• Facility Design
APPLICATION ACROSS SYSTEM
• Value Stream Mapping• Kaizen• 5S • Standard Work• Poke-Yoke• Kanban • Spaghetti Diagrams• Paretos• Level Loading
MOST COMMON TOOLS
Results:• Step Reduction
15%
• Total Process Time Reduction: 44%
• Total Distance Reduction: 46%
EXAMPLE – OR LAYOUT REDESIGN
Source: Joan Wellman Associates
BEFORE
PROJECT EXAMPLE – SUPPLY AREA
Source: Joan Wellman Associates
Results:
• Supply Search Time Reduction 82%
• Total Space Savings: 14%
• Sustainable Visual System implemented to aid timely reordering.
• Strategic Planning• KPI Development• Visual Control Boards• PDCA Culture Initiatives• A3• Daily Huddles• Leadership at the Gemba
MANAGEMENT SYSTEM
• Akron Children’s Hospital: Reduced costs more than $8 million from 2009 to 2011.
• Henry Ford Health System: Reduced inpatient harm rates nearly 25% and achieved cost-savings of $85 per patient.
• Inova: Decreased ER waiting time by 31% and improved operating margin by $10 million.
• Mercy Hospital in Mason City Iowa: Achieved a 53% faster turnaround time for patient blood test results, $470,954 in annual cost savings and $70,000 in construction avoidance.
(Source: Healthcare Value Leaders Network)
OTHER SYSTEM RESULTS
• Seattle Children’s Hospital: Reduced overall patient costs by 3.7% and supply expenses by $2.5 million.
• ThedaCare: Achieved zero medication reconciliation errors for 4 years in a row and reduced readmission rates to less than 12%.
• The Cleveland Clinic has realized over $100 million in savings in the last 5 years.
(Sources: Healthcare Value Leaders Network; the Cleveland Clinic)
OTHER SYSTEM RESULTS
LEAN HEALTHCARE MIGRATION
• Lack of native transformational experience
• Need for strong operational leadership experience
• Establishing Metrics and Alignment skills deeply needed
• “Fresh eyes” can see more waste
MIGRATION DEMAND
MIGRATION INTEREST
MIGRATION INTEREST
Candidates are Seeking a Deeper Connection to their day-to-day work
MIGRATION INTEREST
• Ability to Slow Down• Ability to deal with Complexity and
Ambiguity• Relationship Building/Interpersonal Skills• Excellent Communication Skills• Previous Experience in Business Process
Areas• Transformational experience in different
industries• Optimism and the Ability to Create Pull
SKILLS REQUIRED
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