There is a rigour to Lean thinking that can appear supremely cold and calculating. However, its unwavering focus on “what the customer sees as value” should curry favour with those who are receiving (e.g., paying for) the end product, which ideally equips companies to look after their people and their environment. Welcome to the triple bottom line.

See… it’s not all about the relentless pursuit of cost savings.

There are some very real inefficiencies (waste, or “muda”) that can be rid from any system with this approach. This may be part of the reason we are seeing such approaches embraced in non-traditional areas, including the service industry and, yes, health care.

The Flo Collaborative

The Flo Collaborative kicked off in September 2007 in order to examine and improve the flow of care in Ontario health care. Two Ontario hospitals acted as pilot sites for projects under the Flo Collaborative, working with the regional Local Health Integration Networks (LHIN) and Community Care Access Centres (CCAC). The overall “flow” of care crosses several different organizations; for example, a client/patient moves from admission into a hospital medical unit, receives treatment and care within the hospital, and then transitions from the hospital to receive an appropriate level of care. The approach for improvement includes “The Model for Improvement,” Lean methodology, Six Sigma Tools, and PDSA cycles.

Not surprisingly, many initiatives that offer the possibility for “quick wins” target frontline staff who are actively engaged in their current standard processes. Andrew Ward, Senior Manager at the Erie St Clair CCAC, worked on the pilot project in Windsor between his CCAC and the Hôtel-Dieu Grace Hospital. He explains, “Often times, staff are well aware of shortcomings within the process but remain silent in expressing their ideas for improvement.” He adds that now, because of the Flo Collaborative, staff have greater opportunities to discuss and try new process changes. Often resistance to change is common in such improvement projects; however, Andrew still found an appetite for the improvements: “Many times we overlook that the frontline has lived with their current system inefficiencies and that they want the change, as well.” As with other change efforts, people have to feel comfortable contributing their individual insight to realize the overall process improvements.

Assessing and Influencing Authority
Asked about lessons learned in getting the all-important “buy-in” from “naysayers,” Andrew sees great potential in gaining involvement from the beginning. He says that it is well worth the initial investment in time to determine who has informal authority, in addition to those with formal authority. “No process change is made in a vacuum,” he explains. “Many things must be considered prior to making an adjustment in staff workflow.” Project leads and others within the team need to feel involved in order to want to share information.

There are some natural barriers that people can hit if they take a “business” approach to anything related to health care. Nonetheless, there are some significant improvements to be gained from a systematic approach, such as that with the Flo Collaborative. Like in any change initiative, it is ever so important to unlock the knowledge of the frontline by enabling good two-way communication. Andrew concludes, “By taking the time and identifying team members of formal and informal authority from the beginning, process changes will yield higher and more sustainable outcomes.” Don’t be mistaken: just because it’s soft, doesn’t make it easy.

This originally appeared in the June 2008 e-Newsletter for the Canadian Supply Chain Sector Council (www.supplychaincanada.org).

Tagged as: CCAC, Flo Collaborative, Hotel Dieu Grace Hospital, LHIN, Ontario Health Care

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