Lean methodology brings big results for patient care and the bottom line
St. Thomas, ON – St. Thomas Elgin General Hospital (STEGH) is a top performing hospital in Ontario and patients are reaping the benefits of that achievement. By introducing Lean methodology (called Transforming Care at STEGH) and continuously seeking improvements to the patient care experience, STEGH is at the top of the list on three of five of the province’s pay for performance indicators.
As a leader among 74 hospitals participating in the Ministry of Health and Long-Term Care’s Pay For Results initiative program, STEGH received an additional $1.4 million last year and anticipates another $1.7 million for this year’s results.
The South West LHIN is also financially supporting STEGH for their success in Transforming Care. STEGH received just over $1 million one-time funding (spread over 3 years) to lead a Knowledge Transfer program to share these successful strategies with other community hospitals within the South West LHIN. STEGH’s Transforming Care journey started in August 2011 using the lean approach, which is about working to design, improve, and deliver care as seen through the patient’s eyes.
“A different approach to change is critical to meeting our vision to deliver an excellent patient care experience, every time, while meeting the demands of a rapidly changing health care system,” explains STEGH President and CEO Paul Collins. “Our Transforming Care journey has been focused on re-thinking patient flow throughout the hospital and making significant changes, like those that have resulted in STEGH ranking as the #1 hospital in Ontario for emergency wait times.”
Four senior executives recently returned from a learning trip to Singapore where they met with health officials and visited hospitals further along the Lean path to advance the hospital’s ongoing transforming care work, and to learn more about lean architectural design to inform their upcoming redevelopment build project. This team provided a nursing, physician and financial perspective and the perspective of a front line manager deeply involved in knowledge transfer. The total cost for the site visit to Singapore was $16,000, approximately $4,000 per person.
Dr. Nancy Whitmore STEGH Vice President and Chief of Staff, who went on the trip, says Singapore is several years ahead of STEGH in using Lean concepts to improve their healthcare system. “This is the journey we are on and we are seeing great results that benefit our patients and our community. We need to continue to look for ways to improve and the best examples are not always in our own backyard.”
The team made site visits to eight hospitals and health care facilities, met Ministry of Health officials as well as architects. “This was an enlightening experience to see and understand an advanced healthcare system that has integrated lean thinking and patient centeredness to the extent that they have,” explains VP and Chief Nursing Executive Karen Davies. “This was a very unique and timely opportunity to inform not only our transforming care journey, but our redevelopment project as our tours also included mental health, emergency departments and surgical suites.”
STEGH leaders who attended the site visits were VP/Chief of Staff Dr. Nancy Whitmore, VP/CNE, Karen Davies and VP/CFO Malcolm Hopkins. Each of these VPs lead a patient care value stream at STEGH, which is one of our LEAN management structure changes. Also attending was the Manager of STEGH’s Transforming Care office Mike Norman, who is on the front line of knowledge transfer internally and is leading the knowledge transfer project funded by the LHIN.
What is Lean and how does it improve care?
The lean business approach is based on the Toyota Production System initiated by the Japanese automaker decades ago and responsible for positioning Toyota as the most successful car manufacturer in the world. This approach was eventually adopted by other automakers around the globe and, based on its successful results, migrated to many other sectors. Although more recently adopted in the healthcare sector, there are global examples of successful lean adoption in Hospitals who can demonstrate measurable performance improvement sustained
over many years.
Essentially, the lean approach focuses on what is valued by the customer, in the case of hospitals, the patient, and works to design and deliver care as seen through the patient’s eyes. This involves a deep understanding of care processes and then making changes that reduce unnecessary steps and waste. The result is higher quality and lower cost.
Lean is best implemented as a ‘system’ that involves commitment, involvement and critical thinking from the frontline to the Boardroom. Consistent and continuous learning and improvement in the best interests of patients, is an important feature of lean in health care.