Decreasing Costs by Improving Quality: An Overview of Lean Principles in Healthcare
Decreasing Costs by Improving Quality: An Overview of Lean Principles in Healthcare
The United States spent 19.7% of its GDP on healthcare in 2020, and it’s projected to keep increasing. The US leads in some preventive care but also has a high chronic disease burden and lower life expectancy compared to other OECD countries. The legislative and executive branches have tried to control costs and improve outcomes through new laws and regulations. Compliance programs like MIPS are part of the shift to a value-based healthcare system from a fee-for-service model. Healthcare organizations have attempted to lower costs and improve their processes by implementing Lean principles.
Lean is a manufacturing method developed by Toyota in the 1930s to improve their quality at lower costs. Lean emphasizes consistency and reliability by adding steps to increase value and eliminate waste. While it started as a manufacturing principle, it has since been utilized by multiple industries to improve processes and increase revenue. Lean has five main principles:
- Specify the Value
- Identify the Value Stream
- Make it Flow
- Pull
- Always Improving
Lean healthcare improvements can include shortened patient wait times, decreased medication errors, and decreased administrative burden. When discussing cost reduction and quality improvement, a significant takeaway is reducing excess variation and task redundancy. Understanding staff roles and responsibilities helps reduce administrative burden and increase meaningful productivity.
Healthcare organizations have carried out the principles of Lean with great success and improvement in their care delivery and business outcomes. Denver Health East Side Clinic reduced no-shows for post-partum appointments from 50% to 5% by merging mother’s and child’s appointments using lean principles.
Similarly, Nicklaus Children’s Hospital used Lean tools to reduce inspection times for crash carts from 3 hours to 10 minutes.
To implement lean methodology, there are tools available for any size practice to increase efficiency and reduce waste. This includes tools like Bottleneck Analysis, Poka-Yoke (mistake proofing), Kanban (signaling), and Kaizen (continuous improvement). Lean can help to emphasize the organization’s values and mission while catering to its needs.
Sources:
https://www.purdue.edu/leansixsigmaonline/blog/healthcare-advancement-with-lean-six-sigma/
https://www.sciencedirect.com/science/article/pii/S2352646714000131
https://www.cms.gov/files/document/highlights.pdf
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