Manufacturing’s Role in Lean Healthcare

One of the better presentations I heard recently about lean in healthcare focused on what may be an important trend in this area – manufacturers helping healthcare organizations get better.

            I previously wrote about the scary opportunity of lean healthcare, as described at the recent AME conference by Dr. John Toussaint of Thedacare. A workshop at the same conference featured the efforts of GM to help transform the University of Michigan academic health system.

            I’m sure some of you share the feeling I have of skepticism about whether GM is the best teacher of lean. (Can you say Toyota?) However, GM has learned a few things about lean from the battering it’s taken in the marketplace. And to her credit, Sheila Hainsworth of GM, a lean implementation manager and the conference presenter, admitted that when GM first started to learn about lean from its NUMMI joint venture with Toyota, “we didn’t drive lean into the culture of the organization.”

            In any case, the university undoubtedly is willing to take lessons from GM, regardless of the automaker’s credentials, because the company is a big customer. GM spent $5.3 billion on healthcare in 2005, and when that kind of customer talks, you listen.

            The university perspective was offered by Dr. John Billi, who holds several titles, including associate vice president for medical affairs. UM hospitals and health centers provide 817 beds plus 1.6 million outpatient visits, and employ 10,000. Meanwhile, the medical school has 1500 faculty physicians, 995 resident physicians and 690 medical students.

            GM has been providing training to the medical system, including classes at GM University in Pontiac, a visit to the Lansing Grand River auto plant, and plenty of GM materials, tools and templates. The automaker also coached initial learning projects and provided training for medical system coaches.

            The improvements so far include:

  • An increase in vascular lines placed within 12 hours (an important action for certain heart patients) from 35 percent to 71 percent, reducing by 46 percent the number of cases needing interventional radiology.
  • In surgical ear/nose/throat cases, an increase in the number of histories and physicals completed at pre-op visits from 75 percent to 99 percent.
  • A reduction in the time to schedule MedSport appointments in orthopedics from 23 days to two and a half minutes.

            There are plenty of other examples. The university’s effort (called the Michigan Quality System) is now in its second year and is involved in everything from developing lean leaders to mapping key value streams to broadening the initiative’s rollout.

            What I found most heartening is that Billi (and presumably others at the university) seemed to understand that lean is not a quick fix, and means never-ending continuous improvement.

            “We look at this as the marathon,” he said. “This is the long race.”


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