Week 5 - Integration of Lean into Health Care Culture

Integration of Lean into Health Care Culture QUAL8490: Applications of Lean in Quality Improvement and Safety Management Week 5  Unit Outcomes 5.1 Discuss the role of leadership in promoting a Lean culture within the project setting....

Integration of Lean into Health Care Culture QUAL8490: Applications of Lean in Quality Improvement and Safety Management Week 5  Unit Outcomes 5.1 Discuss the role of leadership in promoting a Lean culture within the project setting. 5.2 Discuss strategies to integrate Lean principles within the project setting. 5.3 Describe the impact of Lean principles on health care culture in the project setting.  Lean Culture in Health Care Refers to shared values, beliefs, behaviours, and practices within an organization o Prioritizes continuous improvement, waste reduction, and is customer focused In health care, Lean culture: o Improves patient outcomes – focuses on eliminating waste and inefficiencies o Enhances staff satisfaction – empowers staff to identify and solve problems o Drives efficiency and cost-effectiveness – helps streamline processes, reduce wait times, and optimize resource utilization (cost savings and improved resource allocation)  What is Leadership? “The ability to formulate a worthy vision and inspire people to make a total, willing, and voluntary commitment to accomplishing or exceeding organizational goals.” – Goetsch & Davis, 2021, pg. 122 Criteria of leaders: o Leaders define and clearly articulate the organization’s mission o Leader set goals, priorities, and standards o Leaders see leadership as a responsibility rather than a privilege of rank o Leaders surround themselves with knowledgeable, strong people who can make a contribution o Leaders earn trust, respect, and integrity  Leadership for Quality Leadership for quality is based on the philosophy that continually improving the performance of people, processes, and products will in turn improve: o Quality o Value o Productivity o Service o Market share o Longevity o Business expansion (more jobs and opportunities for advancement) o Return on investment  Key Elements of Leadership for Quality Customer Focus Primary goal is to meet or exceed customer expectations Obsession with Quality And instilled in the organizations by leaders Recognizing the Structure of Work Work processes are analyzed to determine their appropriate structural makeup (order, tools, motion etc) Freedom Through Control Must ensure employees take control of work processes by collaborating to standardize them Unity of Purpose All pull together to the same end, when they understand, believe and commit to the mission Looking for Faults in Systems Not assessing for or laying blame on people Teamwork A group working together toward a common goal Continuing Education and Training Fundamental element of total quality Emphasis on Best Practices Utilizing best practices to ensure consistent peak performance  How to Lead Change Develop a change picture of what the organization is going to look like after a change Managers can use incentives to promote the change for contributors to the change (can be monetary or non- monetary, but should motivate employees on a personal level) Train, train, train – training should be increased during times of intense change to make sure employees have the skills required during and after the transition period (Goetsch & Davis, 2021, pg. 132)  Case Study Examples Leading lean: A Canadian healthcare leader’s guide (Fine, Golden, Hannam, & Morra, 2009) Recall for promotion of lean culture to impact organizational performance and patient outcomes (operational efficiency, quality of care, financial sustainability): o Leadership commitment o Empowerment of staff o Training and education o Visible leadership  Key Principles of Lean Aligned to Organizational Culture Value – focus on delivering value to the customer by identifying and eliminating waste Value Stream – map and analyze the end-to-end processes to identify value-added activities and eliminate non-value-added activities Flow – ensure smooth and uninterrupted flow of work, materials, and information through the value stream Pull – implement systems and processes that respond to customer demand and pull resources only when needed Continuous Improvement – foster a culture of continuous learning, experimentation, and improvement at all levels of the organization (accountability, collaboration, innovation, customer focus) Importance of Leadership Commitment to Lean Foundational Pillar Setting the Tone Overcoming Resistance Leadership commitment serves as Leaders who visibly endorse and Leadership commitment helps the cornerstone of successful Lean actively participate in Lean initiatives overcome resistance to change by initiatives send a powerful message to instilling confidence, providing Without strong support from upper employees, signaling the direction, and demonstrating the management, Lean transformations organization’s commitment to importance of Lean principles in are unlikely to succeed continuous improvement achieving organizational goals Reflect on leadership commitment within your own organizations  Characteristics of Effective Lean Leaders in Shaping Culture Leaders play a pivotal role in shaping organizational culture by setting the tone, vision, and expectations for behaviour and performance o Commitment – demonstrate a strong commitment to Lean principles; lead by example o Communication – effective communication to cascade Lean goals and expectations o Empowerment – empower employees to contribute ideas, take ownership of process improvements, decision-making and drive change o Continuous Learning – foster a culture of continuous learning and improvement by providing resources and supports for professional development o Vision-clear vision of desired future state through Lean principles and inspire teams to strive for excellence o Accountability- leaders hold themselves and others accountable for results  Prioritization of Lean Principles When prioritizing Lean principles for health care projects, consider the following factors: o Immediate needs and pain points within the organization o Alignment with organization goals and strategic priorities o Availability of resources and support for implementation Discussion: In your groups, discuss how you would prioritize Lean principles based on their potential impact and feasibility within your projects. Then identify the top priorities for integrating Lean principles into your projects.  Importance of Implementing Lean In health care, implementing Lean principles during project execution is crucial Why implement? o Continuous improvement: Eliminate waste, streamline processes, and enhance quality. o Efficiency and effectiveness reduce unnecessary steps, minimize delays and optimize resources o Quality and patient safety standardize procedures, reduce errors, and ensure continuous monitoring. o Engagement and empowerment: empowers staff to take ownership of their work, and drive positive change.  Relevance to Health Care Take a look at how each Lean principle applies to health care projects: Lean Principles Health Care Application Value Stream Mapping visualizing patient care pathways to identify bottlenecks, delays, and inefficiencies in care delivery Waste Reduction minimizing unnecessary steps, redundant processes, and resource wastage to optimize resource utilization and enhance patient outcomes Standardization establishing standardized protocols for clinical procedures, documentation, and communication to ensure consistency and quality of care Continuous Improvement implementing small, iterative changes to healthcare processes based on feedback, data analysis, and performance metrics to drive ongoing improvement Customer Focus tailoring health care services to meet patient preferences, improve patient satisfaction, and enhance the overall patient experience  Case Study Examples Improving Care Delivery Through Lean: Implementation Case Studies (Carman, Paez, Stephens, Lauren, Steven & Callan, 2014). Real Healthcare Examples: 1. Lakeview Healthcare: Implemented Lean to improve patient flow in the ER, resulting in reduced wait times and increased patient satisfaction. 2. Central Hospital: Used Lean to enhance the “door-to-balloon” time for heart attack patients, significantly improving survival rates. 3. Grand Hospital Center: Applied Lean principles to streamline the scheduling process for follow-up appointments, reducing no show rates and improving patient care  Key Strategies for Implementing Lean Utilize Lean Tools: o Value Stream Mapping: Identify waste. o 5S Methodology: Streamline processes. o Kaizen Events: Drive continuous improvement. Empower Frontline Staff: o Provide training and resources. o Encourage active participation and idea contribution. Monitor Progress: o Track KPIs and metrics. o Address deviations promptly. Encourage Collaboration: o Foster open communication. o Share best practices and successes. This Photo by Unknown Author is licensed under CC BY  Evaluating Project Performance against Lean Metrics & KPIs Measure Progress Towards Lean Objectives: o Purpose: Assess progress in waste reduction, process efficiency, and patient satisfaction. o Benefit: Determine if Lean goals are being met. Identify Areas for Improvement: o Purpose: Highlight inefficiencies and underperformance. o Benefit: Pinpoint opportunities for targeted interventions. Drive Continuous Improvement and Patient Safety: o Purpose: Pursue excellence and innovation continuously. o Benefit: Create feedback loops for iterative improvements, fostering a culture of learning and adaptation.  Evaluating Project Performance against Lean Metrics & KPIs Enhance Quality and Patient Safety: o Purpose: Monitor and improve care quality. o Benefit: Use metrics like error rates and patient outcomes to identify improvement areas and implement corrective actions. Foster accountability and transparency: o Purpose: Promote accountability within teams and stakeholders. o Benefit: Use clear metrics to assess contributions and outcomes. Inform decision-making and resource allocation: o Purpose: Provide data-driven insights for strategic decisions. o Benefit: Prioritize initiatives and allocate resources effectively.. KPI examples Trillium Health Partners quality improvement plan o Page 11 GRH Quality Improvement Plan KPI examples Activity With your group, identify 3 KPIs for your project in 5 minutes. They should align with what you goals and objectives are. Be prepared to share with the larger group  Building a Lean Health Care Culture Understanding the current health care culture Assessment of current culture  Hierarchy: Decision-making authority is often concentrated at the top, leading to communication and innovation challenges.  Resistance to Change: Fear of the unknown and job security concerns can cause pushback.  Siloed Departments: Hinders collaboration, information sharing, teamwork and leads to inefficiencies.  Building a Lean Health Care Culture Understanding the current health care culture Readiness for Lean Transformation  Leadership Support: Essential for successful Lean transformation.  Employee Engagement: Motivated and empowered employees are crucial.  Organizational Structure: Flexible structures promote Lean implementation  Identifying Cultural Barriers o Fear of Change: Address through communication, training, and support. o Lack of Buy-In: Build consensus and demonstrate benefits. o Traditional Hierarchies: Foster teamwork and shared responsibility.  Building a Lean Health Care Culture Techniques for engaging stakeholders Stakeholder engagement strategies o Create Cross-Functional Teams: Diverse perspectives and ownership. o Stakeholder Workshops: Gather input and foster collaboration. o Regular Updates: Build trust through transparency. o Seek Input and Feedback: Value and act on stakeholder input. o Training and Education: Empower stakeholders with Lean knowledge. Building a Lean Health Care Culture Techniques for engaging stakeholders Fostering collaboration o Cross-Departmental Projects: Address common challenges together. o Shared Goals: Align objectives across departments. o Regular Meetings: Facilitate open communication. o Recognition and Rewards: Encourage teamwork. o Knowledge Sharing: Exchange best practices and success stories. Building a Lean Health Care Culture Techniques for engaging stakeholders Communication strategies o Clear Messaging: Use simple language and visuals. o Two-Way Communication: Establish channels for feedback. o Tailored Communication: Use various channels to reach all stakeholders. o Storytelling: Share success stories and case studies. o Feedback Loops: Continuously improve communication strategies. This Photo by Unknown Author is licensed under CC BY-NC  Building a Lean Health Care Culture Techniques for engaging stakeholders Measuring cultural impact o Measurement Approaches: Surveys, focus groups, performance metrics. o Qualitative Feedback: Capture insights into cultural shifts. o Performance Metrics: Turnover rates, absenteeism, patient satisfaction scores. o Customized Assessment Tools: Tailored to specific cultural contexts. Activity: with your group, create a survey to understand the impact of Lean on healthcare culture in your organization (5 minutes)  Overcoming Resistance to Change  Understanding Resistance: Fear of the unknown, loss of control.  Strategies: Effective communication, stakeholder engagement, leadership support.  Addressing Cultural Barriers: Foster a culture of continuous improvement.  Anything else?  Establishing Metrics and KPIs Importance of Metrics Establishing metrics and KPIs is essential for evaluating the effectiveness of Lean culture within health care organizations for the following reasons: o Measuring progress – metrics provide tangible data points to assess the progress of Lean initiatives over time o Identifying strengths and weaknesses – metrics help identify areas of strength and weakness within the organization’s Lean culture o Driving accountability – clear metrics create accountability at all levels of the organization o Informing decision-making – metrics provide valuable data for decision- making processes, prioritize initiatives, allocate resources, and make strategic adjustments  Establishing Metrics and KPIs Key Metrics Identifying the right metrics and KPIs is crucial for accurately assessing Lean culture within health care organizations: o Employee engagement – measure employee satisfaction, morale, and commitment to Lean principles. (surveys, feedback mechanisms, retention rates) o Process efficiency – evaluate the efficiency and effectiveness of health care processes. (cycle time, lead time, and throughput) can indicate where improvement can be made o Waste reduction – monitor the reduction of waste within health care processes. (defects, rework, overproduction, waiting times, unnecessary motion, and excess inventory) o Patient satisfaction – assess patient satisfaction levels to determine the impact of Lean initiatives (surveys and patient feedback)  Establishing Metrics and KPIs Setting Targets Once key metrics and KPIs are identified, it's important to establish targets and benchmarks for each metric. Setting targets allows healthcare organizations to: o Measure Progress: Targets provide a benchmark against which progress can be measured. o Drive Improvement: Targets create a sense of urgency and focus on continuous improvement. o Evaluate Success: By comparing actual performance to target performance, organizations can assess whether they are achieving their desired outcomes o Facilitate Accountability: Clear targets promote accountability by clearly defining expectations and responsibilities.  Techniques for Monitoring Progress Regular Reviews Regular reviews and check-ins are essential for ensuring that Lean initiatives remain on track and are aligned to the organization’s goals o Scheduled meetings – regular meetings or check-ins to review performance against established metrics, discuss findings, and identify areas for improvement o Action planning – use regular reviews to develop action plans for addressing identified issues or opportunities for improvement; assign responsibilities, set timelines, and track progress on action items to ensure accountability o Feedback loop – to capture insights and suggestions from stakeholders during regular reviews  Next class Review the Instructional Plan  References Carman, K. L., Paez, K., Stephens, J., Lauren, S., Steven, G., & Callan, B. (2014). Improving care delivery through lean: Implementation case studies. Rockville, MD: Agency for Healthcare Research and Quality. Fine, B. A., Golden, B., Hannam, R., & Morra, D. (2009). Leading lean: a Canadian healthcare leader’s guide. Healthcare Quarterly, 12(3), 32-41. Goetsch, D. L., & Davis, S. B. (2021). Quality management for organizational excellence: Introduction to total quality. Pearson.