Transformation in healthcare

Citation

Downey-Ennis, K. (2007), "Transformation in healthcare", International Journal of Health Care Quality Assurance, Vol. 20 No. 6. https://doi.org/10.1108/ijhcqa.2007.06220faa.001

Transformation in healthcare

The tribute paid to Frank Vergheggen by his many colleagues is both poignant but at the same time inspirational. Frank’s mission was that healthcare would be transformed for the benefit of patient care. So what might transformation mean?

First and foremost it must mean getting rid of the “waste” known as muda by the Japanese. According to Bush (2007) waste unfortunately is endemic in many healthcare organisations and that an epidemic of waste blights the USA health care delivery system. As in any industry, there are seven types of waste in healthcare (Gemba Research, 2007) that describe all activity that adds cost but not value, and must be relentlessly targeted for elimination. Learning to recognize the vast amount of waste that is inherent in many activities is the first step in transforming an organisation (see Table I).

Table I

It is only by tacking these wasteful practices that greater value can be created which in turn will mean staff will have to exert less effort. This can only be achieved through developing and improving processes which will ultimately lead to a better healthcare system for all both patients and employees.

Two methodologies that will help organisations are Six sigma and Lean:

1. 1.

   Six sigma is a process-focused and data driven methodology aimed at near elimination of defects in all processes which are critical to customers (Antony et al., 2005). Six sigma as a powerful business strategy has been around for almost twenty years and has grown significantly in the healthcare industry during the past five years or so in the USA, however it is fair to say this is at the embryonic stage in Europe.

2. 2.

   Lean thinking begins with driving out waste so that all work adds value and serves the needs of the customers. Identifying value added and non value added steps in each and every process begins the journey towards lean operations. In order for lean thinking and principles to take root in healthcare leaders must create a culture that is receptive to thinking lean. The commitment to lean thinking must begin at the top and all staff should be helped in redesigned processes to improve flow and reduce waste. Agreement is growing among healthcare leaders that the principles of lean can reduce the waste that is pervasive in the USA health system and while not a simple task the adoption of lean principles can improve processes and outcomes, reduce costs and increase satisfaction among patients, providers and staff.

While it is true to say that healthcare differs significantly from other industries such as manufacturing where much of lean thinking began there are many similarities. Whether it is making a car or delivering patient care staff rely on many interrelated complex processes to accomplish tasks and to provide value to the customer or patient. Lean and Six Sigma are not management fads, instead they are tried and tested methodologies for improving the way work gets done and both have been spreading inexorably from industry to industry for many years. The principles underpinning these methodologies have been fine tuned, tested, demonstrated and proved, however this has been done largely against the better judgement of people who were doubters and looked at it declaring “it will never work” especially in healthcare where we think we are “so different”.

In remembering Frank Verheggen’s quest for transformation now is the time to take this giant leap forward and improve healthcare for our patients sake through tried and tested approaches. In order for these two methodologies to take root, leaders must first work to create an organizational culture that is receptive to them and the commitment must start at the very top of the organisation, and all staff should be involved in helping to redesign processes to improve flow and reduce waste.

Kay Downey-EnnisCo-Editor