Lean is a philosophy or a mindset, not a tool. Lean is most effective when it becomes the culture of an organization as opposed to simply a series of one-off efficiency projects.

Lean is a patient-focused approach to identifying and eliminating all non-value adding activities and reducing waste within an organization. Value-adding activities are those that the client/patient is willing to pay for. Everything else is waste and should be eliminated, simplified, reduced or integrated. While in a publicly funded health care system, many of our clients do not directly “pay” for services, they do fund services with tax dollars.

Lean is an efficiency and quality improvement strategy that empowers employees, those who know our work processes best and thus have ideas about where we need to make changes, and they then generate and implement innovative solutions.

Lean considers eight major sources of waste:

– Excess motion (e.g., staff searching for supplies, material or information)
– Rework/Defects (e.g., medical errors, forms filled out incorrectly, last minute cancelations of surgeries)
– Overproduction (e.g., taking extra vials of blood “just in case”)
– Excess inventory (e.g., stocking “just in case” inventory rather than “just in time” inventory)
– Wasted intellect (e.g., failing to ask front-line staff for their process improvement ideas, shelving good ideas only to find them later)
– Excess processing (e.g., running routine lab tests; ordering routine chest x-rays on admission when results would not change the course of clinical practice)
– Waiting times (e.g., waiting for results, for information, for appointments, etc.)
– Wasted transportation (e.g., triple hand-offs, ill-planned layout, transporting supplies through multiple redistributions, transferring patients bed to bed)

Although started in the manufacturing sector, the fact remains that the public sector like any other industry – private or public – involves thousands of processes that are intended to offer value for those who use or depend on them. Like other industries, the public sector is interested in delivering quality, cost-effective services that meet the needs of those it serves and creates staff satisfaction. Every step in a process, every decision related to that step must be seen through the eyes of the customer.

Source: Saskatchewan Ministry of Health