Lean Healthcare: A Scary Opportunity

Healthcare, and how it can be improved with lean principles, is simultaneously a huge opportunity and an incredibly scary situation.

            I’ve written about this before (Standard Work Saves Lives). But it’s one thing when I say it. It’s something else when the head of a major healthcare organization makes this point.

            I’m referring to Dr. John Toussaint, CEO of ThedaCare, an operator of hospitals and other healthcare facilities. Toussaint was a keynote speaker at the AME conference in Dallas last week, and he delivered a clear, on-point address about what needs to be done.

            Application of lean to healthcare is an area of growing interest. (There were a few other healthcare-related sessions at the conference, some of which I’ll also be writing about in the near future.) The most encouraging thing about the speech was that Toussaint gets it – he understands what lean is all about, and is a champion for its application.

            “Healthcare is a black box as it relates to performance,” he said. “It’s about time for that to stop. It’s about time to make data-driven decisions.”

            He commented that hospitals have an excellent quality record when it comes to blood transfusions and anesthesia, but quickly noted the reason: “These are the only two things in America done exactly the same at every hospital.”

            He then noted efforts at a Thedacare hospital to improve care related to heart attacks. These efforts focused on making sure that certain simple procedures, which apply to almost all heart attack victims, are performed, and are done when they should be done. These include giving the patient an aspirin, giving the patient a beta blocker, making sure that insertion of an artery-opening catheter occurs within 90 minutes.

            Toussaint said his hospital lowered its defect rate in these areas by one-third. That’s the good news. The bad news is that they still operate at a rate of 66,000 defects per million opportunities – not very good by lean or Six Sigma standards.
            Even worse, the hospital’s performance puts it in the 95^th percentile for all hospitals. Imagine going for treatment to a hospital in the 10^th percentile.

            Beyond the quality issues are the financial issues. “It’s possible to take $1 trillion out of the healthcare system in America,” Toussaint declared.

            The biggest issue in achieving improvement, not surprisingly, is change management. “Our professionals are fearful they’re going to lose control,” he said.

            Toussaint is an early adopter. I hope that he represents the leading edge of a revolution about to take place in the healthcare industry. Our lives may depend on it.