Berlanga - Lean Daily Management for Healthcare Field Book

Lean Daily Management for Healthcare Field Book

Lean Daily Management for Healthcare Field Book

Gerard A. Berlanga Brock C. Husby

CRC Press

Taylor & Francis Group

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Boca Raton, FL 33487-2742

2017 by Taylor & Francis Group, LLC

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Printed on acid-free paper

Version Date: 20160531

International Standard Book Number-13: 978-1-4987-5650-1 (Paperback)

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Library of Congress Cataloging-in-Publication Data

Names: Berlanga, Gerard A., author. | Husby, Brock C., author.

Title: Lean daily management for healthcare field book / Gerard A. Berlanga and Brock C. Husby.

Description: Boca Raton : Taylor & Francis, 2016. | Includes index.

Identifiers: LCCN 2016003773 | ISBN 9781498756501 (alk. paper)

Subjects: | MESH: Health Facility Administration--methods | Health Services Administration | Leadership | Organizational Culture | Quality Improvement

Classification: LCC RA971 | NLM WX 150.1 | DDC 362.1068--dc23

LC record available at http://lccn.loc.gov/2016003773

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Dedication

To my loving wife, Bonnie, who gave me the inspiration to write this book and my late mother, Pauline, who dedicated her life to our family.

Jerry Berlanga

To the wonderful and dedicated leaders, staff, and physicians at Guadalupe Regional Medical Center, who on a daily basis reminded me why I love doing the work that I do through their passion and focus on serving patients and the community.

Brock Husby, PhD

Contents

The success of a new Lean initiative for an organization largely depends on whether there are sustainment efforts and mechanisms in place to support the continuity of such an initiative or not. The transformation of the healthcare industry to be a more patient-centered service enterprise has been a noble goal which requires more than just the promise of contemporary system improvement methods such as Lean and Six Sigma techniques. Piecemeal redesign of healthcare elements with a catalog of successful improvement projects will be beneficial to patients; however, the sustainment of improvements remains the key to any healthcare organization seeking better quality and overall patient experience. Most of the gains from Lean initiatives eventually run into challenges with either sustaining the gains, spreading Lean gains to the rest of the organization, or losing senior leaderships support. The key to a lasting Lean healthcare transformation is to establish a management system for leaders to follow on a day-to-day basis.

A Lean daily management (LDM) system is a disciplined daily approach for an organization to develop its staff, align their efforts, and build a holistic and meaningful set of activities that will help achieve an organizations goals. It fosters a culture of continuous process improvement at the level of greatest value and empowers those doing the work to implement data driven improvements that they believe patients value most. It also enables teams and leaders to communicate daily about root cause challenges and visualizes progress on improvement initiatives. Jerry and Brock have extensive background and experience in applications of Lean concepts and tools in healthcare. They have served as Associate Vice Presidents, coaches, and strategists for lean transformation and operations excellence of leadership teams for several healthcare organizations across the United States and Canada. Their insight into linking LDM to sustainable continuous improvement transformation is a must for healthcare leaders to develop the new habits required to sustain Lean improvements. This book gives readers the important know-how for deploying LDM in their organizations.

F. Frank Chen, PhD

Luther Brown Distinguished Chair
Center for Advanced Manufacturing & Lean Systems
The University of Texas at San Antonio

This field book is a result of years of practicing, teaching, and coaching Lean principles and methods to healthcare leaders and front-line staff across the United States and Canada, as well as many hard-earned lessons and much trial-and-error experimentation to figure out how to make these principles work in a healthcare (and service) environment. Traditional Lean healthcare implementations delivered great short term results, but frequently lost steam as key Lean leaders moved on to other departments or organizations or they solely focused on large projects (such as VSM) or tools (such as 5S). This often led to obscuring the vision of organizations from the true potential of what transformational change their organization was capable of. Lean felt very much like a push onto the organization in the form of rapid improvement Kaizen projects or large-scale Value Stream Mapping projects and associated training that pulled in only a small percentage of leaders and staff and occurred infrequently. When Lean was introduced into organizations in this fashion (as a small number of very discrete events or tools), this definition of what lean is often became crystalized into the mind and culture of the organization, and handicapped the organization from making further progress. The initiatives often devolved into Popcorn Kaizen where lots of activity was taking place, but it didnt link together, change culture, or result in fundamental or long-lasting change.

In healthcare, the underlying waste isnt overproduction as we were taught in traditional manufacturing style Lean training. The underlying waste in healthcare is underutilizing the creativity of our employees/staff and the broken (or missing) management systems that most healthcare organizations struggle to operate within. This waste, and the accompanying opportunity, is even greater in healthcare than in other industries because staffing costs are a significantly higher proportion of expenses in healthcare than in manufacturing. Therefore, the vast experience, passion, knowledge, education, and commitment of the staff are an amazing and positive untapped opportunity.