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Reconstituting lean in healthcare: From waste elimination toward ‘queue…
Reconstituting lean in healthcare: From waste elimination toward ‘queue-less’ patient-focused care
Lean lessons from manufacturing: A
poor fit in healthcare
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how mistakes and weaknesses in lean manufacturing
are being echoed in healthcare.
“Is lean management in
use here?”
Manufacturers have done a poor job of directing their lean efforts toward effectiveness in the eyes of the customer.
Living up to lean’s potential in
healthcare
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Lean healthcare’s skeptics
The lean applications were producing “small-scale and localized productivity gains,” the result of being mired at a lean ‘tools’ level
“healthcare is predominantly designed to be capacity-led,”
Making time for continuous
improvement
Errors are defined as inaccuracies or unnecessary actions occurring within a task
Why shouldn’t healthcare learn lean
from manufacturing?
In this light, the best choices to see lean in action—and learn from it—are in sectors where production is less complex, less automated, and less gigantic.
How the MHI program works
Countering the dominant emphasis on efficiency, the MHI program prioritizes for effectiveness, as measured by quick response and saved lives.
Lean healthcare in method-specific
terms
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Kanban (queue limitation)
Setting quantitative limits on waiting times, both for human and physical entities
Cross training/job rotation
Every position having one or more certified backup staffers, with multi-skilling maintained through job rotation
Visual management
Prominent identifiers of correct locations and quantities of materials, devices, and implements
Value-stream organization
and layout
A facility set up in product-focused or customer-focused (or both) units–—in lean lingo, a work cell (small) or a focused factory (big)
Quick setup
Choreographed methods for quick, error-free setups and changeovers involving physical and human resources
The lean management jungle
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Among the former are value-add/nonvalue-add analysis, value-stream mapping, spaghetti charting, intensive observation, cost analysis, time study, and process simulation and modeling
Lean methodologies subdivide logically into those that study and analyze processes to pinpoint process deficiencies versus those that change processes for the better.
Patient-centered lean
effectiveness as strategy
Two most salient lean-in-healthcare
Quick response with time to care
Quick response: A primary leanhealthcare mission
quick response manufacturing (QRM)