Frontiers of Health Services Management - Spring 2013 - (Page 4)

T he healthcare organizations that are radically redesigning management processes share one characteristic: lean thinking. introduced in the United States in bits and pieces beginning in the early 1900s, lean thinking states that customer needs are a company’s first concern. Henry ford designed mass production systems by beginning with what the customer would pay for (value) and then working backward to design a product and production process to deliver that value to the customer in the least amount of time and with the least amount of waste. ford was also a true value stream thinker, drawing maps of every production process. During World War ii, the US Department of War urgently needed materials from manufacturers that were suddenly staffed with untrained workers. to train a lot of workers quickly, the The most important tool War Department focused we use to understand the on educating the supervisors, or training the traincare delivery process is a ers, and on standardizing value stream map. the work performed. Using process-management concepts, the department launched training Within industry (tWi). Stocked with leanthinking principles, tWi was the linchpin to training millions of unskilled laborers. after World War ii, influential author and consultant W. edwards Deming took many of these ideas—including management by process—to Japan. Japanese companies struggling to overcome the devastation of the war were already bringing radical notions like teamwork, continuous improvement, customer pull, and zero inventories to manufacturing. eventually, executives at toyota Motor company pulled all these ideas together to create the toyota Production System (tPS). now toyota periodically overtakes general Mo- tors (gM) as the largest auto manufacturer in the world (Marr 2009). north american companies have been studying and implementing tPS for two decades now, but similar successes have been elusive. We expect organizations to change—to improve by leaps and bounds—using lean thinking without changing the way leaders lead. We are missing the key ingredient, management by process, whereby leadership is expected to be reliable, standardized in its operations, and accountable to those being served. in his book Out of the Crisis, Deming (1983) described 14 points for an effective management-by-process system. a colleague and i recently published an extensive review of how these principles translate to the healthcare environment (toussaint and Berry 2013), in which we noted the following management-byprocess principles for healthcare: • Value for patients • Clarity of purpose • Continuous improvement (pursuing perfection) • One-piece flow for patient care • Standard work for administration and clinical care • Respect for people these principles are consistent with the five lean principles James P. Womack and Daniel t. Jones (1996) describe for manufacturing in the book Lean Thinking: value, value stream, flow, pull, and pursuing perfection. Here i review these principles and briefly consider the components of management-by-process standard work that flow from these principles (Barnas 2011). first, however, we must understand how the majority of healthcare organizations are led today and why transforma- 4 • f ro ntier s o f h ea lth s e r vic e s ma na g e m e nt 29 :3

Table of Contents for the Digital Edition of Frontiers of Health Services Management - Spring 2013

Frontiers of Health Services Management - Spring 2013
Contents
Frontiers of Health Services Management - Spring 2013
A Management, Leadership, and Board Road Map to Transforming Care for Patients
Pursuing the Perfect Patient Experience
Adapting to the New Healthcare Market
High Reliability: Truly Achieving Healthcare Quality and Safety
Making Lean Progress Last: Why Sustaining Excellence Requires the Right Leadership Framework

Frontiers of Health Services Management - Spring 2013