“Many delivery system leaders have looked to Lean improvement methods to guide care redesign. Also known as the Toyota Production System, Lean seeks to empower frontline staff and their managers to analyze work processes, identify sources of waste, and propose redesigns that streamline and standardize workflows. Citing the successes of a few organizations, some health care leaders treat Lean thinking and methods as optimally positioned to drive major leaps in quality, cost savings, engagement of patients and employees, and even population health. Regrettably, limited evidence supports these high expectations. Lean can contribute to improvement, but successful Lean applications typically yield focused, step-by step improvements rather than dramatic jumps in performance or transformational organizational and culture changes that run broad and deep. Attaining even modest improvements through Lean requires leadership vision, commitment, and investment of substantial time and organizational resources. On its own, Lean lacks capacity to transform culture and generate care that is deeply patient-centered, transcends organizational boundaries, and fosters collaboration for population health among social and medical services. These conclusions come from in-depth Lean implementation studies conducted for the Agency for Healthcare Research and Quality (AHRQ) in 10 diverse delivery systems, as well as over 200 research papers reviewed in 11 literature syntheses.” (http://catalyst.nejm.org/limits-lean-improvement-transformative-care/)
The foregoing quote from the article by Michael I. Harrison, PhD, of the United States Agency for Healthcare Research and Quality (AHRQ) entitled Limits of Lean — Transformative Care Redesign Must Go Beyond Typical Lean-Based Improvements clearly defines the critical success factors for Lean and what results realistically can be expected. By implication, it also identifies critical success factors that are lacking to ensure the “dramatic jumps in performance or transformational organizational and culture changes” that are required “streamline and standardize workflows” in a reliably repeatable manner. Implementation of an IT solution that conforms to the Cloud Healthcare Appliance Real-Time Solution as a Service Reference Architecture (CHARTSaaS RA) will provide these factors in a manner that is directly under the control of healthcare provider subject matter experts with minimal cost and complexity (i.e. — minimal need for IT expertise).
Please validate to your own satisfaction the capability of a CHARTSaaS RA-compatible IT solution to transcend the limitations of Lean and thereby significantly improving healthcare provider processes by reviewing the details in the presentations at these URLS:
https://mix.office.com/MyMixes/Details/19g5mpp3f6qkx
https://mix.office.com/MyMixes/Details/1bp3nuiwdjk86
Healthcare providers will benefit significantly from understanding and appreciating Dr. Harrison’s observations, and then from mitigating the Lean limitations cost-effectively using a CHARTSaaS RA-compatible IT solution. To do so will mitigate medical mistakes (currently the third leading cause of patient deaths per Makaray and Daniel, http://www.bmj.com/content/353/bmj.i2139), thereby will minimize patient adverse events, and will optimize clinical case outcomes while maximizing cost-effectiveness of care and treatment delivery.