Wednesday, October 1, 2014

Gaining a deeper understanding of Lean.

So far, so good with the course, but I haven't by any means internally captured the essence of Lean/Six Sigma. I'm usually a reasonably quick study over time, but after having been steeped in medical knowledge for quite a while, and my own pursuits, it's hard to switch gears and focus with a mind like an open book on something so new and foreign. I'm finding the introduction to be sensible, logical, and even - for someone devoted to basic organization - intuitive. Still, though, I know that acquiring a new set of knowledge takes time (months to years) and experience, and I know that one has to integrate it into one's mindset and life (one’s genetic material) - which may be where process improvement has failed in healthcare.

Process improvement in healthcare has been largely a “pet project” endeavor, somewhat akin to the haphazard development of land in the United States, with efforts of varying vision spurred largely by private motivations rather than collectivity - we’ll put a strip mall here and a housing development there and necessity or not, it’ll work itself out. Process improvement has similarly sprouted up in a non-unified, “siloed” fashion which is one likely reason that cohesive fundamental change in healthcare has not yet occurred. It isn’t that those attempting to improve the current culture aren’t top-notch, but there have been iconoclastic captains for each ship with each vessel running ship its own way, rather than a standardized fleet. Again, perhaps that’s been the American way in most things, but with external pressures (CMS and likely eventually other insurers) arising, forcing an alignment of remuneration with proven, replicable quality, and inevitable consolidation of organizations in the market, there will be a unspoken edict soon for everyone to be on a relatively equal playing field of quality.

So education to me seems to be the way – education such as what I’m attempting to learn now, true education to improve the insight and behavior of those very individuals who are instrumental to the vitality of a healthcare organization. It seems important to educate the involved masses as to how to go about changing the ways of an organization, and therefore its culture. Lean/Six Sigma seems like self-help for organizations, a guidebook for self-improvement. And just like any self-improvement, once you’ve incorporated balanced principles into your psyche – your DNA – you’re a different person.

MP