Gaining a deeper understanding of Lean.

So far, so good with the course, but I haven't by any means internally captured the essence of Lean/Six Sigma. I'm usually a reasonably quick study over time, but after having been steeped in medical knowledge for quite a while, and my own pursuits, it's hard to switch gears and focus with a mind like an open book on something so new and foreign. I'm finding the introduction to be sensible, logical, and even - for someone devoted to basic organization - intuitive. Still, though, I know that acquiring a new set of knowledge takes time (months to years) and experience, and I know that one has to integrate it into one's mindset and life (one’s genetic material) - which may be where process improvement has failed in healthcare.

Process improvement in healthcare has been largely a “pet project” endeavor, somewhat akin to the haphazard development of land in the United States, with efforts of varying vision spurred largely by private motivations rather than collectivity - we’ll put a strip mall here and a housing development there and necessity or not, it’ll work itself out. Process improvement has similarly sprouted up in a non-unified, “siloed” fashion which is one likely reason that cohesive fundamental change in healthcare has not yet occurred. It isn’t that those attempting to improve the current culture aren’t top-notch, but there have been iconoclastic captains for each ship with each vessel running ship its own way, rather than a standardized fleet. Again, perhaps that’s been the American way in most things, but with external pressures (CMS and likely eventually other insurers) arising, forcing an alignment of remuneration with proven, replicable quality, and inevitable consolidation of organizations in the market, there will be a unspoken edict soon for everyone to be on a relatively equal playing field of quality.

So education to me seems to be the way – education such as what I’m attempting to learn now, true education to improve the insight and behavior of those very individuals who are instrumental to the vitality of a healthcare organization. It seems important to educate the involved masses as to how to go about changing the ways of an organization, and therefore its culture. Lean/Six Sigma seems like self-help for organizations, a guidebook for self-improvement. And just like any self-improvement, once you’ve incorporated balanced principles into your psyche – your DNA – you’re a different person.

MP

Process Improvement in Healthcare

I've been working in medicine a fair amount of time now, and one of the main things I've noticed is how each hospital (even within a system) seems to be its own fiefdom, with its own territory, weighted political hierarchies, farming tenants, and roving populations. With such, the obvious corollary is that each hospital has its own way of doing things, for better or for worse, which may or may not result in great quality. As I am someone who enjoys the zen of simplification down to essentials, I have been wondering as a small cog in the massive wheel of the American healthcare system how to reconcile the obvious disparities between different healthcare providers into a more streamlined system? It is easy to get concerned about trying to do so, because many independent-minded individuals might have the fear that their power or choice would be taken away, but actually standardizing a system of inequities would probably be ultimately more wholly beneficial to more people collectively than it is now. Other industries have implemented process improvement globally, and no one is complaining about less product defects or airline crashes. Right now, depending on location, socioeconomic status, education, personality, basic values, and a dash of sheer luck, one could have a vastly different medical experience and outcome in one place than another. This isn't just on the patient side of things, but also on the provider side, which can be extremely frustrating and an impetus to the perceived quality of one's job. If we could even out the experience, standardize the quest for quality for all participants in healthcare - the crossroads for all extant humans as our lives are dependent upon our health which will fail at some moment in time - then possibly we could raise the quality of our health and perhaps even our happiness.

That's a lofty goal, something to keep in mind. For now though, the more immediate and pressing point is to begin learning a system which may help me/us in my/our quest for unified quality. As a physician, I have made a commitment to start learning process improvement and, hopefully, how it can help my medicine.  I'm beginning my journey here, with a course to become a Green Belt in Lean/Six Sigma. Like an intrepid explorer of yore, I will chronicle my journey and God-willing beyond through this blog. I'm excited for my departure, and will let you know my initial impressions in October.

MP