Lean in Health Care

A little over a month ago I had an opportunity to spend about 4 hours in a small-group session with Steven Spear. For those readers who don’t already know, Steve is a researcher and practitioner who has made his name in understanding the Toyota Production System as Toyota actually does it.

He first came to the attention of the “lean” community with the 1999 publication of Decoding the DNA of the Toyota Production System, a paper summarizing his PhD research and dissertation.

Since then he has become active in improving the health care system. I’ll leave a full bio to your Google skills.

While health care certainly has a lot of room for improvement, I think the rest of us have a lot to learn from experience and insights being gained in efforts to apply the TPS to health care.

I plan to put together the next few posts intertwining these topics. But first, I wanted to share some interesting performance numbers we heard from Steven Spear.

  • During a hospital stay in the U.S. health care system, the patient’s risk of being injured or killed by the efforts to deliver treatment are roughly on-par with the risks of base jumping. For those of you who don’t know, base jumping is jumping off ‘B’uildings, ‘A’erials, ‘S’pans and ‘E’arth and (hopefully) then parachuting to a (hopefully) safe landing without hitting the thing you are jumping from.
  • Hour-per-hour, you would be safer on an infantry patrol in Bagdad than staying in a hospital.

Now, before you start shaking your head and pointing out just how terrible this is, please consider:

  • As a product moves through your own system, what are the odds it makes it through absolutely unscathed and in perfect condition? Do you do any better than this?
  • If you were to study your own processes do you honestly think they are any more effective at delivering a defect-free outcome at each and every step?
  • Do you even know where, when, and why, those processes fail to deliver a defect-free outcome?

I would contend that most of us have no idea.

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