Beyond heroes – a lean management systems for healthcare by Kim Barnas
Just finished reading my Kindle edition of this lean book. Great reminder of what I learned a couple of years ago, completing my lean training. Describes how lean was adopted in Theda Healthcare in the US. Not all plain sailing. But lots of lessons learned. And lots of progress made.
Leadership and culture
Barnas puts the challenges to leadership/ management up front – side by side with culture. If lean puts continuous improvement at the centre then how do we sustain the improvements? Q leadership and culture. ‘Leadership succeeds only when it learns to evolve’ and ‘new management duties encouraged everyone to be more respectful, improvement focused and process orientated’.
Principles of lean management system
Barnas describes these, for Thedacare, as:
- Managing by process
- Using A3 and
- Plan-Do-Study-Adjust (‘PDSA’)
Standard work
The emphasis on ‘Standard work’ attracted my attention: ‘they use standard work for all value creating and incidental work in the enterprise – designed, documented and continually audited, revised and improved by line managers and work teams’. Barnas sees stability in work processes underpinning continuous improvemet.
End to end value streams
Thedacare sees the patient as the ‘product’ and the flow of the patient through a cycle of care as the value stream. Barnas noted that most patients pass through more than one value stream. And Thedacare set end to end improvement goals across some of those value streams – with 3 or 4 multidisciplinary kaizen teams.
