Lean Progress at the University of Michigan

Paul Levy

First posted 12/12/11 on Not Running a Hospital

I just listened to an extraordinarily well done webinar from MIT, presented by Dr. John E. Billi, associate dean for clinical affairs at the University of Michigan Medical School and associate vice president for medical affairs at the University of Michigan. John leads the Michigan Quality System, the University of Michigan Health System’s business strategy to transform clinical, academic, and administrative functions through development and deployment of a uniform quality improvement philosophy.

As noted in the webinar summary, the University of Michigan Health System (UMHS) has been on the lean journey for the past six years, creating the Michigan Quality System. UMHS has 20,000 faculty, staff, and trainees. The goal is to create 20,000 problem solvers who are finding and fixing root causes of problems they face daily. Dr. Billi described UMHS’ initial approach, results of early experiments, what leaders learned, and how they adjusted. The discussion covered the transition from scattered projects led by coaches to an integrated approach that incorporates people development and process improvement.

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Now, Let’s Graduate to Lean 404

Paul Levy

First published 6/07/11 on Not Running a Hospital

I am borrowing some slides recently presented by James Womack, of the Lean Enterprise Institute, as a follow-up to my previous post about adoption of the Lean philosophy in an organization. If the description there was Lean 101, this is Lean 404.

It is one thing to talk about reducing waste in a process and to learn techniques for doing so. It is another thing altogether to create the management competencies that permit this kind of process improvement to take place on a sustained basis. As Womack notes in the first slide above, most organizations do not have the competencies in place to do that.

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How Do You Get Lean

Paul Levy

First published 6/6/11 on Not Running a Hospital

Lean is not a program. It is a philosophy of management and of organization in a firm or institution. The LEAN approach to things is based on the concept of reducing waste in a process. In a typical clinical process in a typical hospital, over 90% of the steps taken to deliver care are wasteful, and it is not unusual to be able to reduce that by half. The results are better patient care and better financial results. (Regular readers have seen lots of examples of this from my former hospital.)

A leading figure in the spread of Lean to hospitals is John Toussaint. He was CEO of ThedaCare, in Wisconsin. After leaving that position, he founded the ThedaCare Center for Healthcare Value to spread the word about this approach. The Center has released its first DVD, a 44-minute video that highlights strategy deployment as a core part of the Lean management system at ThedaCare. Here’s a summary:

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Teach the Doctors, Please!


Originally published 2/7/11 on [Not] Running A Hospital

If you read the Boston newspapers, you would think that the most important thing going on in health care is a proposal to move from one kind of insurance payment scheme to another. Reporters seem willing to accept relatively unsupported and undocumented assertions that global payments are working. You have to be persistent to find these sentences in this story:

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