Excalibur PERFECT Healthcare Systems
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Lean Systems at Excalibur

Although healthcare practitioners find it convenient to speak about “Lean Systems”, Six Sigma, Quality Systems and so on as if they were separate entities, we at Excalibur understand that these are ideally seamless elements of a single system. A single healthcare delivery system. Healthcare organizations who have been the most successful with performance improvement have consistently implemented these activities into the daily practice of healthcare.

 

All three of these “strategies” share performance improvement as their primary goal. We find in our client organizations different hierarchies with one or the other of these three systems positioned “above the others”.

 

All have a planning element, an auditing element, and performance measurement element. You find “Error Proofing” as a key tool in Lean and in Quality. You find FMEA (Failure Mode Effects Analysis) in Quality and in Six Sigma. You find some form of process mapping or flowcharting in all three strategies.

 

At Excalibur, we do not simply implement Lean or Six Sigma or a Quality System (whether JCAHO, Baldrige or ISO based) or any of its hybrids. In a typical engagement with our Client, we also integrate and harmonize these systems.

 

Our Clients are often surprised when we explain to them that the bigger challenge in the long term viability of a Lean System is not the technical aspects of performance improvement but rather their culture. At least 25% of our focus when implementing a Lean System is on transforming the culture (the “soil” from our gardening analogy that we discuss in the Consulting section of this site) in which that system will flourish. As we guide and mentor you in redirecting the culture we are always mindful that there are many stakeholders in a healthcare organization.

 

Although healthcare practitioners find it convenient to speak about “Lean Systems”, Six Sigma, Quality Systems and so on as if they were separate entities, we at Excalibur understand that these are ideally seamless elements of a single system.

To uncomplicate culture change, we ask first, “What will be best for the Patient”. We then ask what process improvements, resources, permissions or collaboration do each of the stakeholders need to assure Patient care that is always:

  • Safe
  • Effective
  • Patient Centered
  • Timely
  • Efficient1              1 From the Institute of Medicine:
  • Equitable1               Crossing the Quality Chasm, 2001
 

           What Is a Lean Healthcare System?   

  

A LEAN Healthcare System is an organization of healing professionals whose Patient Care, Service Delivery and Operational Processes are waste free1. The people in a LEAN Healthcare System think, act, solve problems, plan and manage differently than people in any other organization. They understand and apply LEAN tools and analysis methods toward eliminating waste and nonvalue added work on a daily basis. LEAN Systems were pioneered by Henry Ford beginning in 1908 and later expanded by Toyota beginning in the 1950's. The goal of a LEAN System is the error-free and uninterrupted flow of Patients and value-add services2. Achieving flow requires perfecting the performance of each process and using resources more effectively than organizations who do not yet understand "LEAN". Building a LEAN System is a never-ending process requiring great courage by its leaders and practitioners3. There are no spectators in a LEAN System; everyone has a responsibility4. Any focus on Departmental performance is replaced by a focus on "value stream" or system performance5. LEAN Systems are measured and managed on an hour-by-hour basis since one of the key indicators of performance in a LEAN System is Time6. As LEAN Systems are implemented throughout the organization, Safety, Quality, Operating Costs, Timeliness of Care Systems and Patient and Staff Satisfaction7 approach world-class levels of performance.