Want to learn a relatively simple method of making customer-centric improvements to healthcare processes? Then Lean may be the answer! Alan Cooper, a principal at the Tudor Advisory Group, shares his insight into the many Lean projects he’s participated in throughout his healthcare career.

The philosophy behind lean is simple, to continuously improve processes by eliminating waste and adding value in order to increase efficiency and better serve our customers/patients/clients.  Lean is an ever-evolving philosophy used extensively in healthcare that is based on proven principles and methods incorporating a compilation of world-class practices to improve an organization through an evidence-based methodology. Lean focuses on the customer, adding consumer-defined value to its products or services by using its employees, trained in the theory and methodology, to continuously re-design and improve processes to create a more efficient work environment.

The power of lean is the fact that those who directly touch a process are the ones who are tasked with improving it. The benefits of this are twofold: Not only do we get great improvements (nobody knows your job better than you do), but we get instant buy-in and accountability of the newly improved process due to the fact that those doing the work are the one’s changing the way it is done, changes are not being imposed by an “outsider”.

Although Lean began in manufacturing several decades ago, it has been deployed in healthcare since the late 1990’s. The basic Lean philosophy of removing waste fits very nicely into our modern healthcare system, where we use multiple, complex processes, in the delivery of patient care.  Since Lean is scalable, it can be used within a single clinician practice, as well as in the largest hospital and health system, and everywhere in-between. Lean is also applicable in behavioral health organizations, as well as community-based organizations focused on all aspects of population health and wellness.  In fact, through New York State DSRIP funding, Lean has been used in all of these areas as well as in food banks, pediatric clinics, drug rehabilitation centers and care management agencies, to name a few.

Lean has been deployed through several Performing Provider System throughout New York State since the early stages of DSRIP. Although the specific type of deployment and uses of the methodology have varied across the state, Lean consultants from the Tudor Advisory Group have been made available to PPS members to assist in reaching their DSRIP goals, as well as for the overall enhancement of the organization’s operations. Throughout the deployments, we have seen significant improvements in areas such as emergency department and clinic throughput, behavioral health and primary care integration, behavioral health center intake, Hypertension and Diabetes Control, as well as many other areas.

Some specific improvement examples include:

  • 30% reduction in Emergency Department registration time within a tertiary hospital, resulting in decreased “door-doc times”
  • 37% decrease in client intake time and standardization of client intake processes across five drug rehabilitation facilities
  • Significant reduction in patient throughput time resulting in the ability to integrate primary care and behavioral health within a pediatric clinic
  • A 24-hour reduction in patient eligibility identification and enrollment in case coordination and care management services
  • A 22% increase in hypertension control within several clinics
  • 50% reduction in the number of steps necessary to hire a new or replacement employee, resulting in a significant reduction in time-to-hire and overtime costs

These are just some of the metric driven successes that member organizations have seen with the use of Lean philosophy and methodology. In addition to these metrics, the advantages of lean deployment are abundant.  Invariably, organizations that employ Lean see an increase in both employee and customer/client/patient satisfaction.  Employees are engaged and empowered to solve the issues and problems within their work environment, thus feeling valued and trusted to help both themselves and the organization as whole improve. Customers, whether they are patients, clients, or fellow employees, feel the benefit of more efficient processes with less waste, and a more pleasant workforce.

Additionally, since Lean techniques are scalable and can be used anywhere a process exists (which is everywhere) participants in the Lean education sessions tend to use the principles learned in their everyday and work lives. A physician that participated in one of the Lean programs kept the principles that she learned on the whiteboard in her office so she could refer to them as she ran her practice. Anecdotally, her staff was extremely pleased with the new efficiencies they had implemented, with the help of these principles, within the clinic.  Finally, since the consulting team uses the “teach a person to fish” philosophy, once the initial project is completed, attendees in the program continue to use the skills learned to conduct additional Lean projects within their organizations. Program attendees also tend to use “Lean thinking” in their everyday work and life, thus constantly seeking to improve the way they work.

Lean has proven to be a successful philosophy and methodology that has helped thousands of organizations remove waste from their processes and provide more efficiency and value to their customers/patients/clients.  Several Performing Provider Systems have afforded Lean to their member organizations who have reaped the benefits of this exceptional philosophy and process improvement methodology.

Alan Cooper, PhD, is founder and President of the Tudor Group, a strategic organizational transformation firm providing consulting services and education in the areas of operational excellence, organization development (OD), change management, learning, and leadership development, with a specialization in healthcare.  Dr. Cooper spent the first 21 years of his career with the North Shore – LIJ Health System in New York as Vice President for Learning and Innovation, as well as White Plains Hospital where he served as Chief People and Performance Officer. Dr. Cooper has also held the positions of Adjunct Associate Professor at the Zarb School of Business at Hofstra University, Associate Dean for Knowledge Management and Associate Professor at the Hofstra North Shore – LIJ School of Medicine, and Associate Dean and Clinical Professor at the Willumstad School of Business at Adelphi University. Dr. Cooper holds a Ph.D. in psychology and an MBA from Adelphi University, as well as a master’s in education from the University of Cincinnati. He also holds several advanced certificates in leadership and management.