A lean enterprise approach to process improvement in a health care organization

United States health care costs are rising and demand is increasing as the population ages. An already overburdened system is being squeezed more each year. Process improvements are urgently needed, and some health care professionals are looking to lean production principles for answers. Past lean health care initiatives have resulted in islands of success with limited overall impact. A lean enterprise approach that delivers value to all stakeholders and challenges current operational models can result in efficiency improvements and cost reduction while delivering a high quality of care. This study examines a single primary care practice. It is shown that an enterprise level perspective assisted health care professionals in evaluating the goals and metrics that influence their behavior. The practice was analyzed through first hand observations and data collection over a four month period. Physicians and staff were shadowed throughout their daily activities to identify waste and evaluate the impact of lean improvements. This data was supplemented with information captured via work sampling, analysis of monthly reports and metrics, and interviews and meetings with key stakeholders. It was determined that the physician productivity goal was driving dysfunctional behavior, resulting in a deteriorating work-life balance throughout the practice. The potential of this behavior to negatively impact patient satisfaction and quality care delivery also created a reason to change. Lean improvement efforts to address these issues resulted in a redesign of the patient visit schedule to allow more adequate time to address patient care, while also reducing the demand on the overworked physicians and staff. Success with the process led to the realization that medical professionals employ an approach to patient care that emulates lean enterprise principles.

Department dc:contributor.department

System Design and Management Program.

Grantor dc:publisher

Massachusetts Institute of Technology

Year dc:date.issued

2007

Author dc:creator

• Casey, James (James William)

Advisor dc:contributor.advisor

• Ricardo Valerdi.

• System Design and Management Program.

Statement dc:rights

• M.I.T. theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission. See provided URL for inquiries about permission.

Licence dc:rights.uri

• http://dspace.mit.edu/handle/1721.1/7582

Language dc:language.iso

eng

Handle dc:identifier.uri

http://hdl.handle.net/1721.1/42345

OAI identifier oai:identifier

oai:dspace.mit.edu:1721.1/42345