Given the difficulties involved, I ended my first venture into healthcare in May of 1997 thinking it was premature to hope for much progress toward lean healthcare.
And I didn’t return to Mayo for ten years until last week when I spent a day with Dr. Henry Ting, a cardiologist with a natural instinct for process thinking.
We looked carefully at the work his team has done recently to speed patients from the point they suspect they might be having a heart attack - usually far from a hospital - to the point where all appropriate treatments have been applied.
The results are quite dramatic. Rethinking this pathway saves lives -- many lives -- because the more quickly appropriate treatments are applied the more likely the patient is to survive and to survive without major heart damage.
And here’s the really encouraging news: A lean pathway reduces costs for the hospital and makes life better for the staff. It’s a win-win-win. My skepticism on my previous visit was replaced with hope after this visit.
But I also realised while flying home that Dr. Ting’s team had performed a brilliant procedure on one of the easier problems to fix and sustain.
They had analyzed a single pathway and one where the value of saving time is so overwhelmingly obvious that any medical organisation will find it hard not to change its behavior once the sclerotic state of the existing pathway is clearly revealed. (Fortunately, their work is now being successfully paralleled throughout Mayo’s cardiology practice and by similar pioneers along other pathways in many healthcare organizations across the world.)
The hard part for all of us is to tie together these pioneering, single-pathway efforts - which seemed beyond our grasp only 10 years ago.
We need to create a complete lean enterprise in which all pathways have been permanently cleared and the lifestyle of the organisation has been changed as well.
This will require more than lean techniques. It will require new management methods and a new type of leadership.
Given the urgent need for this lean leap, I’m truly delighted that my long-time co-author Dan Jones has taken on the challenge of asking what a truly lean healthcare system will look like.
He is leading the first Global Lean Healthcare Summit in the UK at the end of June in which we will be asking what kind of leadership and what kind of management will be required.
We have invited doctors, senior administrators, nurses, and suppliers to describe the challenge as they see it.
We will then work together to develop hypotheses about creating lean healthcare on a systemic basis that we can all test.
The most gratifying aspect of the recent embrace of lean thinking by the healthcare community - making the upcoming Global Lean Healthcare Summit possible - is that these are the most important value streams in our lives. Indeed, they often determine the length and quality of our lives.
As I told an Australian healthcare audience recently, “Toyota takes better care of car parts than most healthcare organisations take of their patients.” And this is not right! We know how to do better and have a moral obligation to do so.