By Nicholas Schmitz, PMP, LSSBB, and Julie E. Williamson
Nearly every health care professional in every department hopes for positive changes that increase efficiency and throughput while eliminating bottlenecks and process-related headaches. This is certainly the case for those in sterile processing.
While most team members have likely heard of “process improvement” and, perhaps, even lean concepts aimed at bringing about positive change, many struggle in their implementation – and for numerous reasons.
Lean concepts may seem simple; however, a true lean transformation may take years to accomplish (many years, in fact), and that often makes facilities and their departmental leaders afraid to take the first steps. Instead, it may become a goal that just keeps being placed on the backburner, relegated behind other projects deemed higher priority. Instead of steering away from lean projects for fear of long-term commitment and sacrifice, SP leaders can finally commit to taking those first steps toward meaningful transformation – all set into motion by a succession of minor changes as opposed to one massive alteration.
Toyota (the most famous lean practitioner) expresses lean as an integrated system that begins with people at the center of a triangle. Each tenant is represented by a side; the base is the philosophy (what we believe), with technical tools (what we do) and managerial tools (how we manage) each forming a side. This all comes together to create the organizational or lean culture. Lean involves elimination of waste, all while respecting people. This is often missed with early implementations. People often latch onto a few technical tools and it becomes a way to beat up others rather than a tool to provide insight on where improvement can be found. To successfully move to a lean organization is to fundamentally believe that nobody is there to do a bad job. Everyone (as individuals and as a collective group) generally wants to succeed.
Any organization/department will collectively go through the change curve as the tools are implemented and, individually, people will go through that progression as individual jobs/tasks change. The most impactful changes will be accomplished with a succession of minor changes rather than one massive alteration. Here are some key points about lean and how to set realistic expectations:
- Angst and setbacks will arise. This is potentially the most important aspect of any change, and not just lean. Things will not always be as planned, regardless of the preparation that went into it. Don’t let that derail the efforts. Identify the setback, make changes and keep moving forward.
- Communication is critical. It would never be advised to just walk into the department one day and declare that you’re ‘going lean.’ It’s important to engage all members of the department and ensure everyone has a role to play and will be heard. Lean philosophy focuses on the people as much as the process.
- Don’t try to blindly copy what others have done. Surely, we should all learn from the lean leaders, but those lessons should be used to develop your own system of improvement (not merely try to duplicate what another organization has already done). All organizations and departments are different, so you will have your own starting point, culture and goals to accomplish.
- Don’t overthink or over plan. Action, experimentation and learning are as vital as thinking and planning, so don’t be too afraid to get out of the muck and start taking actual steps forward. When we take action, we start to see what works and what doesn’t, and why. That helps us focus on the positives and start seeing progress.
- Get employee/team buy in. Communicate why lean initiatives are being considered and what the expected benefits will be and engage the team in the discussion from the onset. All change can lead to stress and questions, but open dialog helps bring everyone in, which helps lead to success.
- Consider leaning on a different label. “Lean” has some negative connotations (lean living) and it can even come with some negative bias because of previous experiences. This is why it’s wise to borrow from the lean leaders. ThedaCare Improvement System, the Virginia Mason Production System, or the Bolton Improving Care System are not successful because of a name. Quite possibly they were able to achieve that success because it wasn’t called lean. Get creative: find a term and system that works for your own department, organization and culture. Doing so will also allow flexibility to introduce components of Six Sigma and other methodologies.
- Don’t short-change change management. People do adapt and accept change (and often, even thrive in it) but, again, the key is to engage them in the decisions. Any system or change that is forced upon the team will quickly backfire. Remember, this is a marathon, not a sprint, and there are no shortcuts to success. When we take time to do things right (another core component of lean), rewards will follow and you’ll be rewarded.
- Last but not least, avoid equating (higher) cost with “waste.” Sometimes, high(er) costs are a necessary factor in delivery value and quality service to the health care customer and, most importantly, patients. When we keep value and quality at the forefront, everyone wins.
Nicholas Schmitz, PMP, LSSBB is president of Schmitz Consulting LLC and has served as a contributing columnist for the International Association of Healthcare Central Service Materiel Management (IAHCSMM) since 2015. He holds two master’s degrees in organization development and change management, and project management, and is a certified Project Management Professional and Lean Six Sigma Black Belt.
Julie E. Williamson serves as editor and director of communications for IAHCSMM.