Lean can help revolutionize Sask. health care

Wahba is an emergency physician in Saskatoon, STARS Transport physician and a clinical assistant professor at the college of medicine. You may have heard about Saskatchewan physicians participating in a seven-day tour at the public’s expense to become a “lean leader.” I am one of those doctors.

I recently returned from an airbag manufacturing plant in Utah and two hospitals in Washington. I believe it is my responsibility to share with you what I learned.

Autoliv is an airbag manufacturing plant that uses lean as its management philosophy. You may wonder: What are they doing sending a doctor to a factory? Trust me, I wondered the same.

At Autoliv the employees live by the words, “We have one chance to save a person’s life.” What stood out for me was seeing improvements generated at the work front line. Employees are encouraged to think, “What will I do or change today to save more lives?”

Management uses these ideas and guides the improvement process, while the front line staff owns it. This is quite a difference from a traditional top-down management style, and is very empowering for the employees. Embracing this mentality will take some time to get used to in health care, but it has started already.

Virginia Mason Health System and Seattle Children’s Hospital adopted lean in 2000 and 1999 respectively, and are two of the top hospitals in the U.S. Their awards and recognitions are too numerous to list, but easily accessible online. So what did I learn? “Does lean value people?” At the core of lean is respect for the people who do the work. When applied correctly, lean is working in the background to make it easier for staff to deliver better patient care. If lean is making patient care delivery more difficult, we are not doing it right.

This doesn’t mean we abandon it and give up. It means we recognize what didn’t work and try to improve it. This continuous cycle of improvement is central to lean.

“Will people’s roles change?” Yes and no. Lean wants to get the best work out of people — the work for which they are trained and enjoy doing. Some roles may change as staff align their skill sets to the agreed upon work required. Lean does not advocate reducing jobs but emphasizes the right skill set delivered at the right time by the right provider.

“Is lean a cult?” No. It’s a culture. It’s a culture of improvement. It’s a culture of not blaming people but instead looking at where the system failed. It looks at how the system can change to help people not make the same mistakes.

“Will it take time?” Absolutely. “Isn’t that frustrating?” You bet. Representatives from all three organizations stated the first five years are exceptionally difficult. Initially, failures and frustrations are more apparent than gains. But as you experience these setbacks, you learn from each one.

Leaders learn the importance of looking to front-line staff for suggestions for improvement. Front-line staff learn to trust these same leaders who are responsive to patient and staff needs. Our stumbling at the beginning of this adoption of lean is the norm.

I don’t believe in lean because I’m paid to do so. I’m fortunate to be in a position to get paid for what I believe in. I believe in lean because I genuinely think it can take health-care delivery in Saskatchewan to a higher level.

There will be challenges along the way. We all will need to learn to do things differently. As we were told in Seattle, “Take the long term view. (Have) patience, this is generational work.”

We have a great opportunity for Saskatchewan to become a leader of healthcare delivery in North America. There is nothing that I would like more than to have health-care providers from other provinces, states and even countries coming to Saskatchewan 10 years from now to see the improvements we have made.

If we can put patients first and figure out how to make lean work in Saskatchewan, we can revolutionize public health care. After all, isn’t that what we’re known for?