donderdag 10 maart 2011

Lean Management as Radiation Oncologies' new philosophy
including video of largest crossover between healthcare & industry

Our renowned institute has decided to adopt Lean management as its new business philosophy. Why has management decided to do so? For years we struggled with the challenge to do more with less effort. Can we, without increasing the number of staff, create extra capacity to open satellite centers and to extend further? Can we keep up with pressure from the hospital board, government and insurance companies to have innovative, ever better, treatments at ever more competing rates and do so with at least the same quality of care?

Over a year ago the RTT (Radiation Therapy technologists) Section of the department has been using lean tools and principles. Resistance to ‘having to do more and differently (again)’ and especially against any form of standardization has turned into relative calm waters. More time for the important stuff. And even some tasks that don’t have to be done by RTT’s any more.

We celebrated our results so far at Akzo Nobels plant in Sassenheim (NL). The paint factory has been ‘at it’ for three years now. Already Akzo inspired the RTT’s to implement improvementboards, have a daily ops meeting and started with selecting so called ‘lean operators’. But we have also identified the boundaries to our improvement efforts: the only way to make real headway for patients, for quality and dor the departments budget can be found in an interdisciplinary lean cooperation. And to achieve such cooperation the main question was not: how tot get those doctors involved? It was: how to get our executives involved (first).

Press 'CC' for English subtitles

During the Akzo-visit factory manager Gerard Luijten confronted the departments’ executives with the things he’d seen during his earlier Gemba walk in the department. The way Gerard did this was rather impressive: a tough confrontation with several wasteds he’d identified but stating those in a fully neutral way. Things like important information systems not being used because the information that is containes has been proved inaccurate. And not knowing to what specific standard work should adhere, which gives no potential for further improvement.

A visit to Akzo’s factory showed the lean potential. And it showed one is never finished. Even after three years the journey is long but finished. It showed it’s not about implementing a couple of new methods or techniques. It really is a management system. A system that, like at Akzo, can increase capacity by 50% without significant investment, working overtime or working harder. Even more so: the work can be done with less people.

What was key to involve executives? Probably the most important thing, taking them along was focussing on the process form a customers or patients perspective. Literally walk along with patients and experience what they experience. And when the patient is ‘detached’ from the process, then attach yourself to his or her patient status en experience what you go through on you hospital path: waiting, searching for information, getting stuff, speed up and wait again, etc.

I’m truly proud the decision to ‘go lean’ has now formally been taken. Shortly I’ll make suggestions on how to extend the journey to the whole department. So more to follow!

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