Taking Improvement from the Assembly Line to Healthcare, The Application of Lean within the Healthcare Industry, by Ronald Bercaw, CRC Press 2012

Who said you can’t take lean methods and apply them to a healthcare facility peopled with super-smart physicians and impatient patients?  Can kaizen stop healthcare execs from running up big capital equipment and bricks and mortar bills?  And how does simple kaizen help heal broken people and keep the walking wounded upright?  These are all questions that have appeared to The Mill Girl during the last eleven months of check-ups, check-ins, and various diagnostics. 

But that’s what I like about this little book – it’s got great cases, and great before and after improvement stats like the ones we used back in the pioneer times of US kaizen work.  You’ve got cycle times, wasted motion, cluttered work areas, bad or missing information flows in healthcare, just as we had in ugly manufacturing areas.  But the money is bigger – and the opportunities for improvement are just too juicy to ignore.

Take the orthopedic case study Bercaw presents from City General.  “Creating the Ultimate Patient Experience:  A Visit to an Orthopedic Clinic.”  Here the key measures tell a story of wasted time, space, equipment, and more important, underutilized and stressed physicians supported by numerous equally frustrated and pressured x-ray techs, receptionists, etc.  All of these providers are doing the best they can to get patients upright and walking well, but something(s) always gets in the way.   

“Let the data lead you,”  Shewhart Award winner Dorian Shainin

Bercaw demonstrates how mapping the current process, taking numbers, and  watching  flows at various times, the observer can see problem areas – bottlenecks, flow irregularities, and information glitches – it’s all there, you’ve just got to map it and pull the data.  For The Mill Girl, the most important statistics are these:

Patient satisfaction visit length:

Baseline                               3.1 hours

Target                                   1.5 hours

Actual                                   54 minutes

% Change                            (71%)

Further, City General was able to avoid the proposed additional capital expense of adding two new x-ray machines and more exam rooms for physicians.  As so often happens in