Making Hospitals Work, How to improve patient care while saving everyone’s time and hospitals’ resources by Marc Baker, and Ian Taylor with Alan Mitchell, Lean Enterprise Academy 2009
Just as A-3, the powerful problem-solving method I learned at Honda is so effective in manufacturing, A-3 as presented in workbook form in Marking Hospitals Work, will help healthcare professionals clearly define and focus in on “the right problem.” Here the three co-authors start with basic observations, such as number of beds, emergency room waits, length of stay, etc., and work through the causes and possible solutions to the most pressing issues. Although many of us may have come to expect as a patient certain unexplainable delays and communications, these problems indicate a flawed system and this red spiral-bound book may be just the tool teams need to study, take data and fix troubling issues.
As a workbook, readers will find the first four basics of problem-solving:
Part One: Grasping the Situation: What is our Problem?
Part Two: Seeing the Process: What is our Current Condition?
Part Three: Analysing the Situation: learning to think differently
Part Four: Developing Countermeasures: Designing the Future State.
Once the team has gathered and reflected on basic data, the workbook moves to envisioning a future state, redesign of elective surgery, for example, and reflections, what’s next. This is a great starting point for healthcare professionals to experiment with taking basic data – not volumes of detailed observations, but the right numbers that will lead to the right questions about staffing, number of beds, and the outliers. Capacity questions are a great starting point, as Dorian Shainin taught us, for getting a feel for the rhythm and pace of any operation. Good data and periodic observation will also allow team members to identify the one or two major problems whose solution would change the entire landscape. It’s good to note that visual systems play a large part in simplifying and moving work processes along – the more visual and obvious the better. Readers will also see takt times measured and applied to the improved process, as well as target times contained in “A Plan for every patient.” The bigger challenge we’ve seen in many healthcare operations is tying the individual systems flows and events into an integrated patient journey. And with big healthcare institutions offering a wide range of “mixed-model” high volume procedures, the challenge to smooth patient flows along the way, remains.