Columnist wrong on value of lean
Woolsey is a resident of Saskatoon.
With the column Lean poor fit in Sask. health care (SP, Feb. 5) Mark Lemstra again tries to muddy the waters around reforming Saskatchewan’s healthcare system with lean management.
He states that 50 per cent to 75 per cent of all health-care outcomes are due to social factors, and that 80 per cent to 90 per cent of heart disease, Type 2 diabetes and cancers can be prevented through behaviour modification. He also states that 33 per cent of heart attack patients and 19 per cent of stroke patients were referred to cardiac rehabilitation programs, but 40 per cent quit.
Lemstra says that lean won’t have any impact on any of this. He is correct, but he completely misguides the reader into thinking lean somehow is meant to have an impact in these areas. It is not. These are important issues and facts but they have nothing to do with lean management of our health-care system.
If these figures could be brought down significantly with improved social and behaviour education and policy — preventive medicine — the need for a more efficient health-care system would be lessened, but it would still need to be waste-free.
A simple definition of lean is to improve both quality and efficiency by eliminating waste. At its foundation, lean is no more complex than that. I have some training and hands-on experience with lean because the company for which I work has been strictly following these principles for almost 11 years. Our goals are lofty, but we are getting closer all the time.
I have four months’ experience being cared for in a Seattle lean system, and years of contact with our own health system. Lying in a hospital bed with hours to think, my thoughts often turned to lean. I could easily come up with a dozen changes within 200 feet of my bed that would eliminate waste under lean principles.
Anyone who has registered at Royal University Hospital in the past few months will have noticed a tremendous improvement. More often than not, you will be registered within a minute of arriving. This is a result of a lean kaizan event where the process was changed to eliminate waste.
Lemstra is always concerned about patient outcomes. When you don’t have a functioning immune system, imagine how horrifying it is to wait in a chair for 20 minutes beside several people suffering from a cold or flu virus. Lean management reduced this hazard, and can only improve outcomes in the long run.
Employees are happy with the changes as well. I know this because I asked.
The health system is investing in people who will be trained to lead others in this ongoing undertaking. It’s a never-ending process that always has as its focus the end user — the patient. If a process does not improve the patient’s experience and outcome, then it is modified or dropped. It is patient-first, not “We do it this way because we have always done it this way.”
Lean management in health care no longer is a new application and has quickly evolved to stand as its own discipline. It’s easy to find many success stories.
Lemstra is a hardworking researcher and I have learned a lot from his articles, but he is stuck on facts that are likely correct but have nothing to do with lean, regardless of how far he stretches them. He does not have clear understanding of lean’s purpose, goals or processes. In this case, people will have a false impression of lean, and that will damage its chances for success.
This is a complicated issue, and good behaviour and preventive measures are very important, but they belong in their own discussion — one that complements lean management as part of a whole that will drastically improve how health care is delivered in Saskatchewan.
Patient outcomes will improve when our delivery system focuses more on the patient rather than the health system and its players.