HGI News and Editorial

"Convened by the Australasian Lean Healthcare Network and now in its 5th year, this premier healthcare redesign event brought together over 400 champions of innovation from around the country and world. This year saw a particularly diverse range of attendees and speakers, representing the truly cross-disciplinary nature of effective healthcare redesign. It was also a year of many firsts, including the first speaker from Singapore, and first presentation by an architect. The theme this year was "Redesign at Work," emphasising the growing focus on redesigning the work of clinicians, managers, and support staff to improve quality and safety of care delivery. Redesign at Work was explored from four key perspectives through a combination of workshops, panel sessions, keynote speakers and storyboard posters:

•   Designing the health system that flows
•   Designing safer work
•   Innovative models of care
•   Redesigning the supply chain

 The summit provided a unique opportunity to gain knowledge and insight through the lessons learned by others, and network with redesign champions from the healthcare community and beyond.

While there were many highlights, the calibre and diversity of speakers was what truly made the summit memorable. The program featured experts from Australia, New Zealand, Singapore, UK, and USA, representing not only the clinical community, but also architecture, quality improvement, and academia. The following examples illustrate the diversity of topics covered by the speakers. Stefano Scalzo, principal Lyons Architecture, and Dr. Peter Steer, CEO Queensland Children's Health Services, discussed the contribution of Lean Thinking to the development of the new Queensland Children's Hospital design. Jane Gray, from NSW Health Services Performance Improvement Branch, Patient and Carer Experience Team, discussed Experience Based Codesign as an effective tool for improving patient, carer and staff experience of a health service. Marcus Watson, a cognitive systems engineer from the Queensland Skills Development Centre, presented his work on the use of simulations to explore time-critical decision making and verbal communication in complex healthcare environments. Dr. Filomena Sousa, CEO Talsico International, provided insight into the impact of human error on healthcare process, and the frequent lack of consciousness of this theory in our process design. Dr. Terry Platcheck, paediatrician from University of Michigan USA, described a doctor-led redesign journey to improve the daily rounding process. And this is only naming a few! There was also a special guest appearance by the renowned John Shook, Senior Advisor in the Lean Enterprise Institute, who worked for 10 years with Toyota and now consults globally, guiding organisations through the Lean transformation.

Many discussions focussed on redesign tools and lessons learned. However, David Meir, an internationally recognised authority on Lean Manufacturing from the USA, encouraged everyone to take a step back and remember the fundamental principles underpinning redesign and Lean Thinking. In particular, how important it is to not jump to solutions but rather focus on understanding the problem; that process redesign is not a single project but rather about building a culture of continuous improvement; and that ultimately the Lean approach is about developing respect for ALL by encouraging ownership and responsibility."

Most people now know that Lean Thinking is based on the work of Toyota. Toyota has been on a continuous journey of improvement since 1945. From the very beginning Toyota had two guiding principles it wanted to reduce the time taken from order to delivery of its vehicle by eliminating waste, and secondly create a system which treated staff and customers with respect. I am no longer surprised that in presentations as diverse as supply chain or standard work or lean management that the conversation turns to the issue of respect.

Regretfully, our health systems are light years away from treating staff and patients with respect. If they did so we would have a truly remarkable system, less wasteful, safer and with more satisfied staff and patients.

The conference highlighted the interest in Lean Thinking, the growing use of it in the healthcare setting and that at last some governments are actively funding lean redesign.

Michael Szwarcbord is a Director of Lean Healthcare Australia(LHA)
Rosie Adams works for Thinchealth in a joint venture with LHA.

If you would like to know more about Lean Thinking as a management system contact Michael on 0422006762.