104 ◾ Healthcare Value Proposition
Lean in healthcare is a management philosophy that pursues continuous improvement methodologies to create the most value for the patient. It targets the most value-eroding aspects of care delivery, such as wait times, long lines, delays, transportation, unsafe practices, and hospital-acquired infections. Lean in healthcare seeks to investigate the timeline from the moment a patient enters the system (either in person or via a phone call, an email, or otherwise) to the time when their needs have been met or their issues resolved. Lean aims to reduce that timeline by eliminating non-valueadded activities or waste.
The Lean Process The following steps are vital to the successful implementation of a lean culture: 1. Understanding the Patient: In Chapter 2, we discussed the need to define value in the context of the patient’s experience, both clinical and non-clinical. A critical starting point for Lean is the process of thoroughly understanding what the patient values, given his/her condition and circumstances. The concept of value varies from patient to patient. The lean approach begins with a detailed understanding of what value the customer assigns to products and services, which determines what the customer will pay. Establishing value allows organizations to create a top-down target price. Subsequently, the cost to produce products and services is determined. The organization focuses on eliminating waste to deliver the value the customer expects at the highest profitability. Value is created by the producer, and in this case, by the healthcare delivery system and/or facility. From a patient’s standpoint, this is why healthcare organizations exist. Value can only be defined by the ultimate customer—the patient. What a patient values can range from empathy, safety, or a resolution of the chief complaint to a physician’s willingness to speak with the patient’s family member. Once an organization understands what the patient values, it must seek to develop a mechanism for measuring it and creating services and processes that satisfy patients’ needs. 2. Identify all the Steps in the Value Stream for Patient Categories: The value stream is the totality of the patients’ journey (life cycle) throughout the duration of the visit, the conditions, interactions, etc. Processes
