why hospitals are looking to an automaker for operational guidance

Without a doubt, two of the most important metrics for any hospital — public or private — are patient outcomes and cost savings. While these two considerations may seem so diametrically opposed that there is no good way to improve them simultaneously, this isn’t necessarily the case.

Indeed, private hospitals across the nation have long been using a system known as lean management, borrowed directly from the automaker Toyota, that has been definitively linked to improvements in both efficiency and quality.

The lean management system is predicated on the notion that small changes can produce a significant impact. As applied to private hospitals, this has meant things like changes to important, yet seemingly mundane, functions like scheduling surgeries, discharging patients and even organizing supply closets.

Regarding this last point, proponents of the system argue the use of simple labels and assigned locations can make supply closets much easier to navigate, meaning medical teams can mobilize more quickly and spend more time with patients rather than needlessly searching for implements.

Interestingly, reports indicate more public hospitals, eager to keep the growing number of insured patients coming through their doors, are now adopting the same Toyota lean management approach in their everyday operations with some reporting considerable success.

For example, a study by the nonprofit California HealthCare Foundation found five public hospitals — one in the Los Angeles area and four in the San Francisco area — which introduced the lean management system have seen drops in prescription errors, reductions in the number of days patients spend in the hospital and decreases in patient wait times. Furthermore, one reported saving almost half a million dollars via reductions in surgery cancellations.

There are some, however, that are not entirely on board with the idea of introducing Toyota’s lean management to public hospitals settings.

For example, National Nurses United indicates the system attempts to standardize the tasks associated with nursing care, much like a robot on an assembly line, in order to maximize productivity. This, the group argues, is an impossibility given the critical thinking and judgment otherwise required in every medical situation.

It remains to be seen how much the system of lean management will catch on in public hospital settings and, if so, whether we will see any noticeable improvement in cost savings and, more significantly, patient outcomes.

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