Lean thinking to better understand process improvement

As a registered nurse, I've been privileged to work alongside some of the most talented and brilliant nurses, providers, technicians, and other professionals in the acute care setting. Healthcare professionals are phenomenal critical thinkers when it comes to managing patient care and keeping our loved ones safe. But is there a difference between clinical expertise and operational efficiency? I certainly believe so and I'll be honest that I was not clever enough to learn that independently. A lean trained expert taught me the value of being a lean thinker and problem solver to uncover those tedious workflow wastes and inefficiencies that our staff tolerate as part of the job. I was taught to see clinical challenges and performance issues with a different perspective, a continuous process improvement perspective.

Lean training taught me the importance of asking why. Why is a great question that helps debunk bad information and open the path to objective, data driven, and fact-based discovery. Why? First, a couple of truths that lean experts often promote - 1. There are no villains in the process improvement effort. Only good people who care about our patients who are doing the work they are trained to do. Introducing process improvement methods in a non-punitive way allows for multidisciplinary teams to collaborate, be less defensive, and can help avoid unnecessary finger pointing. 2. No workflow process or way of doing the work should ever be sacred. Even the best designed processes break over time when the needs of patient care evolve and are no longer served by how we have always done things. It is ok to examine a process, recognize a need to change, and build a new plan that allows care team member to take better care of our patients. 3. The people who do the work are the experts who should be a part of troubleshooting and redesigning the work. Confused about why we do what we do? Ask the people doing it! I promise it is an eye-opening experience, especially for those leaders removed from the clinical environment. As a leader, caring for and protecting the worker experience depends on shared governance structure where those doing the work have co-ownership of how the work is best done. 4. The process of improving healthcare workflows, quality, safety, and performance measures is not a one and done effort. It takes time, consistent effort, a willingness to fail, small wins, and a commitment to regularly evaluate results. There is no magic, only continuous process improvement effort.

Healthcare is a complex industry, challenging, demanding, and for those patient facing clinicians it is a genuinely exhausting experience. In my opinion, formed by years of working in various clinical settings; creating a work environment that better supports the care team members responsible for delivering excellent patient care is as much a priority as the care provided. Arguably, one cannot happen without the other. Lean thinking and problem-solving strategies have an important role to play in our workplace. It is up to those leaders responsible for safeguarding patient care outcomes to recognize the need for change and to promote a healthy process improvement culture that supports our care givers, protects our patients, and gets better results. Don't have a lean program or lean trained staff? You should. Disclaimer: I make that statement as a biased healthcare worker and leader who believes in the value of lean methodology.

Steven Corey RN MSN MBA

Experienced healthcare leader

Advocate of Lean Strategy

Butwhythoughpi.org