Becoming Lean

Written by John G. Hill, president and CEO

In the background of the political firestorm of healthcare reform, hospitals and providers are preparing for the reality that the healthcare system we know today will be forever changed. As a result of this uncertainty, lean is emerging as the new hospital industry "buzz word." It symbolizes the need for continuous improvement of the delivery system and business model of the United States healthcare system.

Lean is a production practice that considers resources used for any other purpose than to create value for the end customer, as "wasteful". The lean methodology originated in Japan after World War II, when American occupation forces brought in process improvement experts, W. Edwards Deming and Joseph M. Juran, to assist in restoring the Japanese manufacturing industry. The Toyota Production System is the most often cited example of lean methodology, which has helped build Toyota into a global auto industry leader by creating more value with less work.

I discovered the benefits of lean principals 30 years ago when my dad took our family on a 24-mile "rim to rim" backpack trip through the Grand Canyon. During the three day trip, I spent a good amount of time off loading unnecessary items or "waste" into campground garbage bins, my dad's backpack and joyfully tossing items from my backpack into the mighty Colorado River. Three days later, having completed the trip at the North Rim of the canyon, I had a refined understanding of the importance of ultra light backpacking. That early lesson of being lean is often recited to my kids as we head off into the Rocky Mountain West each fall for our family backpacking adventures.

At The Medical Center of Aurora and Centennial Medical Plaza, lean principles are actively practiced as a set of "tools" that helps our organization to identify and steadily eliminate waste in the delivery of care to our shared patients. As steps are eliminated from hospital systems, it is our hope that quality improves, and service delivery times and costs are reduced. Since 2007, our organization has been actively introducing lean principles into the three key areas of our organization: the Culture, our Business, and Key Performance Systems.

The results are materializing by measurable improvement in our 5 Key Indicators of Success: Patient Loyalty, Employee Pride, Physician Engagement, Financial Commitment, and Community Involvement. Receiving recognition as a Magnet Hospital for Nursing Excellence, Top 100 "Best Places to Work" by Modern Healthcare, and achieving the Timberline Award from the Colorado Performance Excellence Organization, indicates we are making continual progress as a lean organization. However, we still have a tremendous opportunity for hospital system improvements as represented by our Medical Staff's steady communication of problem areas through the Physician Hot Line.

We invite you to help us maintain a culture of continuous process improvement and to become lean through suggesting ways to improve the patient experience and delivery of care throughout our organization.