Harvard Vanguard Medical Associates and Beth Israel Deaconess Medical Center (BIDMC) recently co-hosted 40 members of the Healthcare Value Network (HVN) for a 3 day visit to learn more about Harvard Vanguard and BIDMC’s successes using Lean process improvement. Lean is a methodology that enables organizations to identify and remove wasteful and inefficient processes while adding value to the patient or customer. The HVN (part of the ThedaCare Center for Healthcare Value) is a collaborative of healthcare leaders who share a commitment to providing high-quality, cost-effective care through the application of lean concepts. HVN members are invited to participate in “gemba visits” several times a year which include on-site tours at host organizations that have implemented Lean processes.
The Boston gemba visit took place in October 2013 beginning with a visit to the Concord practice of Harvard Vanguard. Harvard Vanguard leadership provided an overview of how Lean has been used across the organization since 2009, and they also shared some results and learnings from the ongoing work. Next, attendees toured the Concord practice to observe first-hand the patient-friendly design and layout of the office and to talk with staff about their use of lean methodology in their daily work. The Concord practice recently opened a brand new facility which was designed using Lean processes and principles to create a better patient experience, including:
- Standard Exam Rooms: All exam rooms are set-up with the same medical supplies in the same place, with the quantities needed for the day. This helps keep the visit on-time and allows the clinician to have more time with the patient because they do not have to leave the exam room to search for supplies. This has also greatly reduced inventory cost for the Concord site.
- “Pod” designs for clinical staff: Both the Internal Medicine and Pediatrics departments were designed to have the clinical teams located closely together (co-located), to enable better communication during a visit and for after-visit work such as follow-up with patients on lab results.
Day two featured a trip in town to Boston to visit the BIDMC campus. Staff at BIDMC provided an overview of their Lean work and tours were given of the Gastrointestinal Endoscopy suite, Food Services department, and the Intensive Care Units, all of which implemented new processes using Lean.
The final day of the gemba visit featured the joint Lean work of Harvard Vanguard and BIDMC in the areas of reducing avoidable emergency department admissions and improving prenatal care for OBGYN patients.
HVN members shared positive feedback about the 3-day trip and learned many ideas to bring back to their organizations in regard to leveraging lean to improve patient care.
