Health Care Process Improvement

Added on Feb 16, 2017

Health Care Process Improvement
By Charles Hagood, Partner, Press Ganey Consulting Services
Industry Edge February 2017

The U.S. health care industry is experiencing change unlike any other time in modern history. The rising costs of care and those associated with new regulatory requirements are straining health systems’ bottom lines.

At the same time, in the shift toward value-based care, patient expectations are changing. Patients are starting to exert their power as consumers by making more demands on the health care provider-patient relationship. They want higher standards of care, more information about their treatment, more involvement in decisions about their care, and transparency of cost and performance data to help inform their care choices.

Together, these considerations are shifting the health care marketplace and forcing health systems to transform their clinical operations to improve the safety, quality and experience of the care they deliver and to reduce costs.

As a result, hospitals and health systems are increasingly adopting and adapting proven methodologies from other industries to optimize efficiency and improve outcomes. The Lean quality improvement methodology is an example. A hallmark of the Toyota Production System, Lean comprises a set of core principles for maximizing value from the customers’ perspective and eliminating waste.

With rising pressure to reduce costs and improve quality, an increasing number of organizations are looking to Lean and similar tools for breakthrough solutions, but the results have been mixed. This is not because the methodology is flawed—it is used successfully in most global industries and virtually all organizational sectors— but because the principles, which are a set of tools, are not being fully integrated into a system of process improvement.

The belief that a set of tools such as a “six-pack of Kaizen events” or an “A3” tool will alone transform an organization into a model of efficiency over the long term is wishful thinking. The missing link for many organizations seeking a long-term and sustainable solution is the appreciation of the difference between a system of improvement and a set of tools.

Among some of the essential features of a system of improvement, the following elements are necessary for achieving operational and quality improvements that are sustainable over the long term:

1. An organizational strategy focused toward a “true north” mission, to which all improvement work will be aligned
2. Deployment of the strategy throughout the entire organization, from the boardroom to the C-suite to the front line, with both outcome and process metrics established to evaluate progress at each level of the organization
3. Lean-related tools for driving improvement, such as Kaizen events, value stream mapping, root cause analyses, A3 problem solving, kanban and pull systems, 5S workplace organization methods and many others
4. Leadership Standard Work, which outlines the expectations and tasks for leaders to support the system of improvement at all levels of the organization
5. Daily management systems, which support the daily problem solving and execution of strategy throughout the organization
6. Organizational development and training activities that are focused on training everyone in the organization at all levels in the tools and methods of the improvement system, as well as ongoing monitoring of the cultural aspects of the transformation

As this list indicates, process improvement tools are an essential component of a successful transformation strategy, but they are only a part of the whole. Their promise can only be realized if they are implemented and monitored as part of a well-defined, highly reliable system of improvement.