What does Lean have to do with hospital beds?

There is a tendency to automatically associate Lean practices with products and production, posing a challenge in fostering a culture where it can be recognized as a tool for health care. As previously stated, however, Lean is a customer driven initiative. In health care, patients are customers and seeing things from their point of view is where an ethical Lean journey should begin.

The Boston Consulting Group and the University of Pennsylvania Wharton describe an approach to reducing waste and increasing "profit" in a hospital setting in their Special Report, Rethinking Lean: Beyond the Shop Floor. Partner and managing director at BCG Jon Scholl describes how a shorter hospital stay results in a quicker turnover of beds where hospitals can treat more patients without additional capital investment:

...a hospital with 800 beds that cuts average length of stay by just 10% can free up nearly 80 beds per year, enabling the delivery of more than 4,000 additional procedures and boosting operating profit by almost $30 million. 

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This seems like a pretty cold blooded and bureaucratic approach to caring for sick people. Or does it?

Overwhelmingly, patients surveyed reported more time spent waiting than anything else, beginning from the time they scheduled their appointment. Waiting is one of the 7 wastes in Lean. Booking appointments several weeks in advance leads to no-shows and consequent idle time. Another source of waiting occurs when patients are handed off between different types of medical professionals. A Lean approach to care might assemble a team that focuses on one patient at a time. Chris P. Lee, a professor of operations and information management at Wharton, explains “This reduces hand offs, it reduces medical errors, it reduces length of stay, and it improves patient satisfaction greatly.

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Ultimately, the biggest challenge to implementing improved systems in health care might be the actual time needed to focus on it. If you visit a clinic or hospital, you don't see nurses, doctors, or staff sitting around with nothing to do. They are all educated in their work, ambitious about helping patients, and have an interest in the reduction of pain and suffering. It takes a commitment at the management level to ensure that once the facility initiates their Lean journey, it will be funded, supported, and sustained.