Wednesday, June 15, 2011

Will we ever get to this point?

An April 5 article in the Financial Times presented the story of a number of German industrial groups that have found success by selling manufacturing skills to external clients. Entitled "Profits of Inside Knowledge," the story focuses on Lean process improvement expertise. Here are some excerpts:

[A]fter the Porsche management brought in Japanese lean production techniques, overhauling the German company’s inefficient production system and network of suppliers, they discovered that there was demand from suppliers for their expertise.

The secret to the consultancies’ success lies in a rather unusual approach. Unlike most consultancies, Fischer Prozessberatung and the German sports car maker do not proffer legions of immaculate suits fresh from business school but rather experts from their shop floors.

“Some of our consultants go to the assembly plants of engineering companies and, after three days, start moving around machinery with a crane to improve production efficiency. Which consultancy would do something similar?” asks Eberhard Weiblen, Porsche Consulting’s chief executive.

As we consider the possible value of Lean in the hospital world, is it too much to imagine the same thing occurring in health care? Imagine a hospital getting so good at reducing waste that it would be asked by its medical device suppliers or other vendors to assist in making those companies more efficient.

Well, maybe we are getting a little ahead of ourselves. First, let's get good at this in the clinical setting. As Jim Womack says,


Anonymous said...

Would that health care could be made safer and better by coming in and moving things around with a crane. Unfortunately what we have to move is people's attitudes, a far more difficult task. Virginia Mason Medical Center actually has an Institute which exports this health care knowledge - but here is an observation from their book "Transforming Health Care" (p. 172):

"Through the years, many calls to Virginia Mason have come from quality improvement personnel or clinicians who feel a sense of urgency about change that is not shared by leaders of their institutions......many calls would begin with......"Ive been trying to get my executives to let me do this here. Can I bring them to Virginia Mason so you guys can convince them for me?'........leadership from the top of an organization is essential to success with VMPS" (their Lean system)

nonlocal MD

Anonymous said...

I second that. These should be the roles of governance and management: to 1) see the flows, 2) collaborate, and 3) provide better patient experience and outcomes. Not just maximize 'less time, less effort, less cost'. How quickly leaders import talent rather than maximizing the voice of their own in house.

I would hazard that the number one inefficiency in any system is the loss of inside knowledge. Did anyone on the line through the years at Porsche think "this is a wasteful way of doing things" but "since no one could care less what I think, I'll keep my job by letting them think that they are doing theirs." No doubt that by moving machinery around, old hats have new eyes. But, how often does the furniture get moved around the top floor? When the consultants leave, do the leaders listen any differently? Usually not.

Anonymous said...

Your comment, anon 8:56, is a thoughtful one and reminds me that Paul has spent a lot of time on this blog asking for changes in medical education to reflect our concerns - but who is training hospital administrators? Some rare and treasured leaders, like Paul, know this stuff intuitively, but most must be taught. Perhaps these principles should be incorporated into Masters of Health Administration programs or wherever it is that hospital leaders get trained. (Outside the rarified world of Boston and outside AMC's, few hospital administrators have M.D.'s)

nonlocal MD