Recently, in talking with some hospitals I have discovered that many have taken what they call a “lean path” to improvement.  A short surf to some of the forums that support conversations about this path has people sending pictures of cleaned up areas using 5S (discussed in my post: 5S in Hospitals and Service).  No wonder hospitals need to have Employee Assistance Program representatives on standby to help employees cope with the stress caused by change.

The movement of hospitals running around finding a best method for everything seems plausible, but they miss bigger opportunities to change their systems so nurses and other workers don’t have to go to the psychiatric couch.  Worse, many of the lean implementations are sub-optimizing their systems by improvement department by department.  This means one piece or finction is optimized but the overall system pays the price.

Why does this happen?  The problem is the inside-out approach that is too often taken.  I have found the better approach is to start with demand from the outside-in.  After all, why spend time on improving a hospital based off another hospital’s demand . . . which is what copying gives you.

Every hospital system is different by demand, structure, work design, technology, policies, people, etc.  Making assumptions to achieve a best practice can be costly.

Studying the type and frequency of demand and whether the demand is of value or failure (demand caused a failure to do something or do something right for a customer) can give us a better starting point.  All this can be learned at the points of transactions that customers communicate demands to your hospital.  Hospitals can be better informed about their system because looking at things from a customer’s point of view gives us new perspective.

The important thing about this customer perspective is that customers don’t see functions they see a hospital system.  Understanding customer purpose (what matters to them) leads to better systemic measures.  This helps shift the focus from internal to external . . . it is one system after all.

5S and other tools distract from the system and management focuses on the wrong or “functional” measures.  This creates a missed opportunity to redesign the work to accommodate customer demand through systemic changes.  

 This has led to arguments that may not benefit anyone between systems thinking and lean crowds, but I believe these are important arguments as the tool-based approach is missing huge opportunity to change thinking and get far more comprehensive systemic changes.  I doubt there will be lean people converted.  However, it is important to know there is a different and from what I have seen better approach.

Leave me a comment. . . share your opinion!  Click on comments below.

Make the new decade a profitable and rewarding one, start a new path here.  Download free from www.newsystemsthinking.com “Understanding Your Organization as a System” and gain knowledge of systems thinking or contact us about how to get started at tripp@newsystemsthinking.com.  Reach him on Twitter at www.twitter.com/TriBabbittor LinkedIn at www.linkedin.com/in/trippbabbitt.