Identifying new opportunities to be Lean

In a recent Healthcare Finance article, Sherree Geyer discussed how Lean Six Sigma, which began in auto manufacturing in the 1990s, is becoming more widely used in healthcare. According to Geyer, Lean Six Sigma “involves the standardization of processes, making sure work is done the best way every time with the fewest number of steps.”

While being Lean can mean something different to every healthcare organization, at its core, it is about reducing cost through the elimination of variation and waste in order to provide the best, most efficient patient care.

As pressures mount on healthcare executives to do more with less, it is easy to understand why they are increasingly embracing the Lean philosophy. Health systems are regularly attacking long ER wait times to reduce non-value adding time; utilizing design and construction to maximize physical structures; developing processes to reduce OR room turnover times; implementing just-in-time inventory strategies; using technology to improve processes and eliminate waste; and developing their people to streamline and improve and ultimately become more Lean.

It is not difficult to find examples of what healthcare organizations ARE doing. But, what aren’t they doing? Are there areas of waste and variation within healthcare organizations that aren’t yet on leadership’s radar?

One example is intersite logistics, or healthcare transportation, the physical movement of patient and business critical supplies—such as laboratory specimens, pharmaceuticals, equipment, med-surg supplies, mail, print shop materials, etc.—across a healthcare organization’s entire network.

Finding untapped areas of waste within transportation networks

Intersite logistics, or healthcare transportation, touches nearly every area and site within a healthcare organization. But because it is typically never greater than a fraction of a percent of a health system’s total expenditure, most healthcare executives—including financial leaders—overlook it as a large area of opportunity.

As a result, most healthcare transportation systems have operated largely independently of each other, allowing for high levels of waste, overlap and variation in processes. Some examples of this waste include:

• Laboratory overstaffing due to variable specimen arrival and later than optimal arrival at conclusion of the day.
• Extra inventory at facilities sitting on shelves, risking expiration that could instead be shared system-wide and better utilized.
• Capital equipment sitting idle when it could be shared/used by another facility.
• Multiple, decentralized and redundant lab, pharmacy, print and mail operations.
• Different couriers from the lab, pharmacy and supply chain all pulling up to a hospital at the same time to pick up specimens, pharmaceuticals and equipment that are ultimately being delivered to the same locations.
• Hospitals, clinics and other facilities receiving more (or less) pickup/delivery stops than required to meet clinical needs.
• Manual processes for tracking chain of custody that wastes clinical time and increases risk.
• Facilities ordering on-demand/STAT service, when regular scheduled service will suffice, creating unnecessary work for the transportation department and possibly the recipient of the item, and increasing transportation costs.
• Clinicians wasting time waiting for delayed or lost specimens, equipment and/or supplies.

Transportation impacts almost every element and every department of a health system. Deploying a healthcare transportation network to enhance intersite logistics can provide significant savings opportunities that are several times higher than the direct savings cost of transportation alone.

A well-designed centralized transportation network creates a mechanism to utilize network connectivity, to deliver and deploy all goods and services throughout the intersite network in an efficient, consistent and reliable manner.

Unifying transportation is not an end in and of itself, but is a means to create other opportunities for operational standardization, to eliminate waste along entire value streams, in keeping with the Lean philosophy.

Intersite healthcare transportation is just one example of some areas that may be untapped from a Lean perspective. What other areas can you uncover?

Jake Crampton is CEO of MedSpeed.