I wanted to see how the journey described in the Times compared with area hospitals, so I asked Sheri Eschete of Thibodaux Regional Medical Center to relate the article to her own experiences.

It was a great article. It paints a VERY true picture of the benefits and challenges faced when trying to implement Lean in healthcare. With every project, we are faced with the mindset of  “each patient is different, so we can’t have a standardized process, because it depends………..”.   My answer to that is, all the more reason to have a standardized process!  In healthcare we have to look at the patients as the variables in the process and the disease states, diagnostic testing, and other services as the processes.  You can’t eliminate variables, but you can establish efficient, standardized processes to make sure that each patient receives the same appropriate care every time, by every staff member.  Eliminating decision points in healthcare delivery helps to reduce opportunities for errors.

It was encouraging to see Lean Thinking examples in the article which we also used to improve services.  Lean has greatly improved our Imaging Services by accommodating same day appointments and a 90% reduction in turnaround time. This allows us to be competitive with free standing Imaging Centers.  Results are available within a few hours of the procedure instead of days.  Projects have been done in many areas to improve turnaround time, patient throughput and eliminate wasted motion…all to benefit patients and staff.

I do want to reiterate a point in the article concerning the culture shift required for Lean to be successful.  Lean does require total support from the top in order to allocate time and other resources needed to implement Lean Thinking.  It takes a true commitment from leaders to realize the benefits through Lean.  It needs to be part of the way you do business and not just a sideline project for short term gains.

It is common to hear that healthcare is different.  We are not different!  We are inundated with processes, performed daily, with desired outcomes. We expect people to perform them flawlessly each day. Lean can help to develop and continuously improve these daily tasks. It is a strive for perfection………and healthcare is the perfect industry for perfection.

Sheri is the Six Sigma Master Black Belt for Thibodaux Regional Medical Center in Thibodaux, LA, an award-winning 185-bed facility that has won recognition for customer and patient excellence.  Sheri also serves on the Advisory Board for the Center for Lean Excellence.

Two Principles of Lean classes were held, as well as current- and future-state Value Stream Mapping sessions.  A 5S Workforce organization session was brought to the work floor.  In addition, management and supervisory personnel were coached on their roles in ensuring the success of the outcome.

“Using Lean Solutions, we identified steps that maximize efficiencies within the Louisiana Workforce Commission’s claims operations,” Barfield added.  “These improvements should roll out in the next few weeks and we expect them to result in faster payment of claims.”  Barfield was recently appointed as Executive Counsel for Governor Bobby Jindal.

Forward-thinking leaders are realizing that not only can they manage their government expenses with Lean thinking, they can actually improve the level of service!  Lean focuses on identifying and eliminating eight primary areas of waste, listed here with a few examples:

• Defects: Data entry errors, pricing errors, missing information, missed specifications, lost records, misspelled street signs
• Overproduction: Producing in excess of customer requests, or before the customer requires it,  creating more information than the process requires, creating reports that no one reads, making extra copies
• Waiting: Waiting for faxes, for the system to come back up, the copy machine, a customer’s response, a handed-off file to come back, for repair parts
• Non-Value Added Processing: Performing more than the customer requires or desires, creating reports that are not used, repeated manual entry of data, use of outdated standard forms, use of inappropriate software
• Transportation: Retrieving or storing physical files, carrying documents to and from shared equipment, taking files to another person, going to get signatures; multiple approvals; multiple handoffs, going back to the central warehouse for equipment
• Inventory: Files waiting to be worked on, permits to be approved, inspections waiting for completion,  stored unused records, excess equipment, obsolete repair parts; batch processing reports
• Motion: Searching for files, extra clicks or key strokes, repeated data entry, looking through books for information, handling paperwork
• Underutilized Employees: Unbalanced workload, unplanned maintenance, misuse of automation, limited employee authority and responsibility, overbearing command and control.

When you understand these wastes, you begin to see them.  And more importantly, when your employees understand them, they see them as well.  That said, you don’t want to rush out and make wholesale changes to your processes without considering the overall impact of the change.  To prevent moving a problem to another group, you must look at an entire process, not just portions within a single activity area.  One of the best ways to do this is with a value-stream map, or VSM, which clearly identifies the entire process.

Value stream mapping is one of the most basic foundations for any Lean initiative.  You can learn more about how value stream mapping can be effectively used to identify wastes in your organization by contacting us for a free assessment of your operations.

“As a pioneer of Lean in healthcare, our organization wasn’t quite sure of what to expect, and even had some doubt as to if the Lean methodology could be successfully implemented in a non-manufacturing environment. Early successes eliminated all doubt as we improved efficiency in several areas of our organization, resulting in decreased wait times, improved cycle times, optimized process flow, and increased customer and staff satisfaction. After five years, we are continuing to leverage Lean to achieve excellence in providing high quality patient care.”

Greg Stock, President & CEO
Thibodaux Regional Medical Center

By closely looking at individual processes, heathcare providers can identify and eliminate activities that contirute to the delay.  In many cases, such as in cardiac pathways, the reduction in time can literally be a difference between life and death.  A typical example may reduce the ‘door to balloon’ time, or the time from arrival at the emergency room to the time the patient is catheterized to the point of the attack, from in excess of an hour and a half to well below 60 minutes.

Even in more mundane clinical treatments, eliminating time delays in clinical processes can mean speedier delivery of services.

Contact usto find out how we can help you improve your services!

This waste is inherent in almost every organization – from non-profits to businesses to government.  The wastes are time spent by personnel doing things that aren’t necessary to deliver the service being requested.  By eliminating these wastes, government can speed permit review times, road repair response times, maintenance activities, and even emergency response times.

In the business world, the elimination of these wastes is called “Lean Thinking”.  It’s what put Toyota, Honda, and many other Japanese companies on the map.  Health care facilities are rapidly adopting Lean principles to the time it takes for incoming patients to receive lifesaving treatment.

In Lean, there are eight wastes:  waiting, excess inventory, non-value-added processing, transportation of materials and equipment, motion, mistakes, over-production and underutilized people.

The key to removing these wastes are in looking for them – and they’re right before your eyes:

Watching a Xerox machine run (underutilized people);  asking for information (waiting); making more forms than necessary (excess inventory); moving documents over long distances (transportation); storing processed documents (overproduction); rework (mistakes); and redundant  checking (non-value-added processing).  Do some of these look familiar?

Corinne Dupuy, director of the Center for Lean Excellence at the University of Louisiana at Lafayette says the time involved in almost any process can be dramatically reduced, quality of service improved, and overall costs reduced.  With the backing of the university and Louisiana Economic Development, the center was created to focus on using Lean techniques to transform Louisiana’s public and private sectors.  The Center applies the tried and true principles that made Toyota and Honda what they are today:  start at the top, train your people in the basics, use some high-level tools to identify your pilot areas, then work with your employees to eliminate the wastes and make your constituents more satisfied.

Louisiana communities must improve their quality of services.  In the current environment, tax increases to fund improved services will be hard to come by.  So, as an elected official or administrator, you’re faced with improving services by hiring additional people, making existing employees work longer hours, or buying new equipment; all of which cost extra money that you don’t have.  Or, you could work smarter, not harder, by using the principles of Lean to make your community a better place.

The Center for Lean Excellence will not only educate companies from the areas impacted by hurricanes Katrina and Rita on lean tools to help them return to business, but also educate and facilitate the positive transformation of Louisiana’s industry and government.

“Companies small and large across South Louisiana are turning the hurricanes’ impact into an opportunity to improve their business models,” said Louisiana Economic Development Secretary Michael J. Olivier. “This center will provide a new resource for those looking to become more efficient and successful. We see this as a way for Louisiana to lead the nation in the transition to lean manufacturing processes.”

The event will take place in New Orleans tomorrow at a workshop where business leaders from the impacted areas will learn more about lean principles.

The Association for Manufacturing Excellence is a not-for-profit association of over 5,000 members dedicated to the sharing of knowledge on leading-edge topics that help companies stay competitive in a global marketplace. AME cultivates understanding, helps members analyze and exchange ideas on productivity methods, and teaches how these methods can be successfully applied in the pursuit of excellence. For more information, visit http://www.ame.org

MEPOL, a University of Louisiana at Lafayette program, is a non-profit dedicated to the promotion of Louisiana’s manufacturers. As part of the nationwide National Institute of Technology’s (NIST) Manufacturing Extension Partnership (MEP), MEPOL has a built-in network to assist manufacturers in a myriad of professional services including lean manufacturing, grant assistance, prototyping, and marketing. For more information, visit http://www.mepol.org

New Orleans, Louisiana, October 3, 2007 – The Association for Manufacturing Excellence (AME), a not-for-profit association dedicated to the sharing of information to help companies stay competitive in a global marketplace, has donated $50,000 to help fund the creation of a Center of Excellence for Lean Initiatives. The center will be based at the Manufacturing Extension Partnership of Louisiana (MEPOL) at the University of Louisiana-Lafayette.   The Center will create a place where companies from the impacted areas of Hurricanes Katrina and Rita can learn about ways to use Lean tools to help them get back up running, become more successful, and provide employment opportunities in these devastated communities.

“American manufacturers face huge challenges competing in a global marketplace and Lean manufacturing is the only answer to win the fight,” says Ralph Keller, president of the Association for Manufacturing Excellence. “The Center of Excellence for Lean Initiatives will be the only center of its type in the country where manufacturers can about Lean principles from other manufacturers.”

The funding for the AME donation comes from the group’s Katrina Fund that was built using a portion of the admission fee from AME’s 2006 National Conference in Dallas. Keller says the center will be of great benefit to manufacturing companies in Louisiana looking to recover from the damage inflicted by Hurricanes Katrina and Rita in 2005.

“The Center of Excellence strikes at the core of what AME is all about. Not only will it provide assistance to help those companies affected by Katrina, but will plant the seed of future success on a global scale,” says Keith Syberg, Chairman of AME. “My hope is that this center will help companies in the South, and throughout America, lean how to lead their industries through the adaptation of Lean.”

In addition to AME’s donation, the Louisiana State Department of Economic Development is matching the grant 100% to help get the project off the ground.

The check presentation ceremony for the center took place today at the University of New Orleans, where a group of executives from the hurricane areas were being taught the principles of lean.

About AME
The Association for Manufacturing Excellence is a not-for-profit association of over 5,000 members dedicated to the sharing of knowledge on leading-edge topics that help companies stay competitive in a global marketplace. AME cultivates understanding, helps members analyze and exchange ideas on productivity methods, and teaches how these methods can be successfully applied in the pursuit of excellence.

Since its founding in 1985, the Association for Manufacturing Excellence has expanded its focus beyond manufacturing to many functional areas of the enterprise and into many industries, all of which benefit from advanced management techniques. AME is practitioner-based, and its events and workshops focus on hands-on learning and knowledge exchange among peers. For more information visit www.ame.org or email info@ame.org.