Thursday, April 02, 2009

Residents learn LEAN, too





Part of BIDMC SPIRIT is to infuse many of the LEAN process improvement principles throughout the hospital. A key constituency in this effort are the residents who, after all, spend as much time on the patient care floors as anybody. So, we have begun a training program for this group, and the first sessions were held this week.

Shown here is Alice Lee, our LEAN guru, er, sensei, conducting a class. Also, you see a couple of the students on the floors, quietly observing things and learning how to look for waste and opportunities for efficiency improvements.

11 comments:

Marty Bonick said...

The work you have accomplished through the SPIRIT program is very impressive! I think its a great idea to get your future physicians involved at the ground level as well. It will serve them well in the future at understanding how hospitals work and the efforts it takes to create sustained change in a complex environment.

Are the education and tools you have used to develop and manage the SPIRIT program proprietary or were they created with help from the outside? Our management team has been contemplating how to start a program like this of our own, but we haven't quite figured out how to get this off the ground yet. Would appreciate any help you could provide in pointing us in the right direction. Thank you!

Paul Levy said...

Marty,

Of course, we are happy to share anything we have.

Anonymous said...

i guess they don't have enough to do learning how to practice medicine in their already shortened training hours?

Paul Levy said...

Aha! What they are learning is how to make more efficient use of their hours of work.

Staight said...

I think this work is fantastic! After all,lean improvements can be applied throughout a healthcare facility to achieve improvements in infection rates, medical records and pharmaceutical errors, bed turnover, emergency room bottlenecks, supplies and equipment availability, and patient satisfaction.

Novaces (http://www.novaces.com/healthcare.php) has a great illustration of how a hospital in Turkey decided to focus lean efforts on improving the process of patient billing and reducing handoffs. They were able to achieve a 67% improvement and patients, of course, are more likely to pay and have a positive experience if billing is handled right the first time

Janice Hwang said...

As one of the BIDMC medicine residents who had the privilege of participating in the lean retreat this week, I can truly say that this has been one of the most valuable experiences of my medical training. As young doctors, we are constantly pushing ourselves to work harder and faster to provide the best care for our patients in a chaotic system. How eye-opening to see that there are feasible and systematic ways to make my work more efficient, more effective, and ultimately, more satisfying to my patients! I am so grateful for the opportunity to learn about lean methodology and can't wait to start implementing this in my work. I feel very lucky to work in a hospital where there is a culture of constant improvement. I only wish I had learned about this stuff sooner!

Anonymous said...

As a participant in this most recent Lean course, I can whole heartedly say that it was one of the most valuable learning experiences of my residency. The experience transformed how I understand the care we deliver as an institution and as a healthcare system in general. More importantly though, the course helped me to begin to understand the opportunities for reforming and improving the care we provide. This type of training needs to be integrated into residencies across the country, and should continue at BIDMC. I want to thank the leadership of BIDMC for having the vision and the willingness to support these initiatives. It was immensely valuable to each of us on the team. On behalf of the entire Lean team, Dan Meyer

Anonymous said...

I am a nurse at BIDMC on a medical floor. I was also a participant in this LEAN event. The entire experience was transformative! It not only gave each individual a different sense of their own practice, but of the work of other disciplines. So often we perform the same work in parallel of each other. This week taught me so much about seeing the inefficiencies in my own job, but, also, about the opporunity to work collaboratively with others to benefit our patients!

kathy welch said...

As a case manager involved in this extraordinary project, I come away not only looking at the world differently, but with knowledge on how to use this in my own work environment This past week taught me the importance of one another as a team and that the key word is communicate!Change is difficult but it CAN be done in tiny increments. NO MAN IS AN ISLAND.Each of us has some value to share with one another and each voice is as important as the next one.Channelling that communication into a workable plan is essential. Thanks to all on this team for the experience and the acknowledgement that we are all working for the same goal- excellence in patient care and outcome

Christine Peoples said...

As a current BIDMC resident, I was fortunate enough to participate in the first QI retreat/LEAN event. The entire experience completely changed how I will deliver care to my patients. By truly organizing our workflow around the patient, I was inspired to re-define my approach to patient care. I will take the knowledge and skills that I learned throughout this week and apply them to my future career. I knew when I picked BIDMC for my residency that it was an amazing program. This week made me appreciate just how wonderful a place it is to work and care for patients on a day-to-day basis!!! It was one of the most valuable experiences that I have had during my residency training.

Anonymous said...

2.5 months later, what changes, if any, have been accomplished?

how many of the interns have become more efficient at discharging and less efficient at learning how to practice medicine?