Mark Graban's "Lean for Haiti"

Today's blog entry features a special note from Mark Graban, author of the book Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction and founder and lead contributor of LeanBlog.org:

January 12 marked the one-year anniversary of the earthquake that devastated Haiti in January of 2010.

Last year, I was fortunate to meet a special person -- Russell Maroni, an x-ray tech at Akron Children's Hospital. He volunteered in Haiti for 15 days in February 2010 as part of the earthquake relief efforts. He was unexpectedly, and necessarily, pressed into service in a medical role, not only caring for patients, but also using his formal lean training from ACH to help improve processes and radiology patient throughput at a field hospital.

Russell wrote a very compelling, and very personal, journal during his time in Haiti. He and his colleagues took many pictures. We are sharing this all in a PDF eBook that we are freely distributing - to share the story and to create awareness for Haiti relief needs. We are asking people who read the book to consider donating to the Friends of the Orphans, which runs an orphanage in Haiti.

The journal isn't mainly a 'lean story,' although it does include his hand-drawn A3 plan. It's a very personal story, of his own prayer and contemplation of the trip, and his experiences in the midst of that tragedy.

To read more, go to the
Lean for Haiti site, which has links to the PDF and other social media sites for the relief effort.


Barnes-Jewish Hospital (St. Louis) and its Lean Results

According to a recent article over on the STL Today website, Barnes-Jewish Hospital in St. Louis has seen dramatic improvements during the past five years with its "patient-centered care" approach. With the hospital's focus on value stream analyses and standardized work, the term "patient-centered care" is quite synonymous with Lean management.

According to Dr. John Lynch (vice president and chief medical officer), streamlining the hospitals preparations for surgery saved about $1 million in 2010. The hospital performs about 40,000 surgeries per year. In addition, standardizing the installation of patients' intravenous lines "lowered the hospital's central line bloodstream infection rate by 40 percent in the last year."

I think Dr. Lynch's reply to the criticism that these techniques might cause rote "cookie-cutter care" is important -- according to Dr. Lynch "we only use standardization when it makes sense." The hospital does not resemble an assembly line: "We're more like a body shop, where every car comes in with its own problems," Lynch says. "We always allow room for individual patient variation. We're not telling the surgeon where to cut."

Although Barnes-Jewish hospital has put such tools as kanban, poke-yoke, and root-cause analysis to great use, the major area for improvement is the reduction of wait time in the emergency department. Solutions here are difficult because of the dramatic increase of patient visits each year. Do any readers of this blog have some suggestions for increasing the efficiency for admitting patients? Should the focus be on decreasing the wait time or adding value to the wait time?