Starting with Lean


I had a great conversation with a new friend yesterday. He’s a dentist and is looking to drive continuous improvement within his small organization. He’s feeling overwhelmed, since he’s busy with being a dentist, running an office, and managing a small team adding any extra responsibility seems like it’d put him over the top. He wants to do process improvement because he things that there’s a lot of waste in his small organization but he is terrified of starting because it seems like more work that he doesn’t have time for.

This isn’t the first time I’ve heard of a Dentist wanting to improve processes or go Lean. While working at Samsung I watched a Webinar about the Lean Dentist, Sami Bahri, who several years ago began to implement Lean at his dental practice. He’s since gone on to write two book, one of specific importance to both Healthcare and Dentistry: Single Patient Flow. This really turns the concept of provider centric care on its head. The goal of Single Patient Flow is to maximize the “utilization” of the patient. No, this doesn’t mean treat patients with unneeded tests to keep them “busy.”

No it means that we need to measure the value added component of their time in the clinic and set a goal of that as close to 100% as possible. This means warm hand-offs between any assistants and the doctor, it means no waiting in the waiting room. No waiting in the office for people to come. None of this is something that we’re willing to pay for, yet we must pay for it. Actually in most cases our employers are paying for it through lost productivity at our jobs.

Moving towards patient centric offices also changes the how the patient expects to interact with you. They will know more because they did some research coming in, this information could be wrong so it will take more time to explain to them the correct diagnosis. People using WebMD is a result of dissatisfaction with existing doctor offices.

Becoming more patient centric is a big deal and takes a lot of work. Where do you start? With anything. Yes that’s a bit of a cop out statement, but it’s also true. Pick anything that is causing pain for either your staff or your patients and map it out. Figure out what the process currently and where the wastes are. Work to eliminate them. Start with something small like how you answer the phone or greet the patient when they walk in the door. Figure out who should be doing this and how to ensure it’s the right person doing this work.

Start somewhere. Start where you can have a quick win. Start where you think it will help the patient quickest first.

2 thoughts on “Starting with Lean

  1. En Fisioterapia Bando, te tratarán fisioterapeutas colegiados,
    que darán la mejor respuesta a tu inconveniente. ), Europa del Este , Lo que si
    tengo una bolita que se me ha echo realmente difícil suprimir ya sea con ejercicio
    con eso de la yesoterapia.

  2. This really should be a matter of public interest, for all doctors’ offices to go Lean. The amount of time and resource wasted due to poor or – in most cases – no planning at all is appalling. Lean and Agile have been around for over a decade now, with almost all industries taking a shot at making it happen for it – healthcare seems to be very slow to catch up. I’d love to recommend a nice post on getting started to all healthcare offices managers: http://kanbantool.com/kanban-library/kanban-kick-start/kanban-its-easy-to-get-started – it really is not so hard to start with a small change and then build on it. I’m really looking forward to the day when going to the doctor’s will not entail a 3 hour wait for NO REASON at all.

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