Management Improvement in Healthcare

Posted on October 9, 2005 by John Hunter

Thinking out-of-the-box Helps Alexandra Hospital Reduce Patient Waiting Time, Singapore News, via Panta Rei.

Another example of lean principles being used by government:

When looking for solutions to cut patients’ waiting time, Alexandra Hospital took an out-of-the-box approach and looked at a factory’s production line. More specifically, the Toyota production line.
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While a team of 12 staff used to screen 22 patients per hour, the same team can now screen 70 patients per hour – a 400-per-cent increase in productivity
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This… is how hospitals should look for new ways to deliver better healthcare at a lower cost. To encourage this, the Ministry of Health has set up the Healthcare Quality Improvement Fund which will provide seed money to fund projects which would improve the quality of patient care.


What’s so Bad about Assembly Line Healthcare? [the broken link was removed], Panta Rei:

I have to confess having much less success at persuading hospitals in the U.S. to take a serious look at TPS. People with the letters M.D. after their name are particularly resistant to being placed, or having their patients placed on any kind of “production line” healthcare.

Health care (and especially M.D.s) have always been seen as among the most difficult environment to introduce new management principles (universities are another). It was surprising to me since so much of management improvement is largely about using the scientific method, but it seems to be a reality. It seems these highly educated people are used to having huge freedom to act as they wish, and seem to resist participating in a system to improve rather than doing as they wish.

To improving results in health care I strongly recommend looking at the work of the Institute for Healthcare Improvement. They have an excellent article on lean, Going Lean in Health Care [the broken link was removed] by James Womack et. al. (previous post on Going Lean in Health Care).

I also recommend the value of considering the experience of SSM Health Care [the broken link was removed]. They were the first winner’s of the Baldrige National Quality Award for Health Care. While not lean focused I think the trouble of getting doctors to consider management systems improvement would be very similar. I heard Sister Mary Jean Ryan, President-CEO speak at the Hunter Conference on Quality in 2000 and she seemed to really understand this issue and the need for systemic improvement.

The healthcare system is in need of improvement: USA Health Care Costs reach 15.3% of GDP – the highest percentage ever.

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