Using Health Information Technology and Lean Six Sigma to Optimize Health Care

In the November 2012 issue, we wrote about Lean Healthcare projects representing a huge step forward in patient care efficiencies and process improvements for the citizens of the Nation’s communities, and we’ve received overwhelmingly positive feedback from the participating hospitals. For example, feedback from Becky Sanders, Indiana Telehealth Network Director, and project coordinator from IRHA indicates that from a base of 20 participating hospitals, 135 healthcare workers earned Lean Healthcare Yellow Belt Certifications through a local University, and 40 of these workers went on to earn either their Green Belt or Black Belt Certifications. The Lean-Teams worked on emergency department patient throughput, readmissions, or transitions of care. The team from one participating Hospital combined two focus areas and was able to apply Lean principles and methodologies through Lean Healthcare training and project-based coaching to reduce by 70% the cycle time from emergency department discharge disposition to med-surge unit admission.

 

In this Month’s article, we will discuss progress over the past few years, in which technology has taken a pivotal role in Healthcare reform and the many reasons for this. The healthcare field in the United States is faced with three main challenges: 1) access to healthcare, 2) quality of healthcare, and 3) controlling the costs of healthcare. To better manage most of these challenges, Healthcare Organizations (HCOs) have to adopt new tools we call the twin-engines of Lean Healthcare optimization: Health Information Technology (HIT) and Lean Six Sigma.

 

HIT is a specialized Information Technology (IT) solution for Healthcare, and has the ability to capture, process, archive, and retrieve clinical information electronically. With these capabilities, HIT can make HCOs more productive and reduce healthcare costs. It also can identify medical faults, alert healthcare workers, and even prevent mistakes. In 1999, The Institute of Medicine reported that between 44,000 to 98,000 patients died in the United States due to preventable mistakes, and HIT can be one of the tools to prevent such errors. However, many HCOs have not exploited HIT in order to assist in overcoming the aforementioned healthcare issues.

 

Six Sigma is a fact-based, data-driven quality improvement philosophy that has been highly effective across many industries. Lean Production is a production system whose main objective is to eliminate waste by concurrently reducing or minimizing supplier, customer, and internal variability. Lean Production concepts are widely used in manufacturing and service sector organizations for process improvement. Lean Six Sigma (LSS) is an approach that combines Six Sigma and Lean Production within the context of process and service excellence, and can be used in any organization, including health care.

 

In today’s health care environment, clinicians and managers must optimize their own organizations. Empirical data has shown that the costs of health care services are inflated with 30-80% waste. Health care services have little or no history using data and systematic approaches to process improvement. Moreover, change control and documentation is missing in many health care settings, making it difficult to determine process baselines and to ensure permanence of process improvement.

 

 

LSS represents a great opportunity for improving quality and speed in the delivery of health care services. It is also an excellent way to address some of the new Federal mandates of the "National Strategy for Quality Improvement in Health Care" that is part of the Affordable Care Act.