Can Lean Healthcare Really Succeed?

I was talking to a doctor I know recently who was lementing the fact that he is not very good with computers.  He mentioned a time in his life when he had to learn about Gantt charts and what a dreadful ordeal it was for him to have to explore such a foreign concept. He added, however, that he thought it was a good tool. And he remarked, almost off-handedly, that you could develop a patient's entire treatment plan with a Gantt chart.

This was the first great realization that I had. I've been thinking so much about how process improvement tools can help in the healthcare industry, but I hadn't thought about using project management tools. It makes me wonder what other opportunities we're missing in this arena.

The second realization I had came with the doctor's next comment, regarding using Gantt charts to track a patient's treatment. He added that the insurance companies would love it, but that no doctor in the world would ever sign up for it. Then it hit me. Doctors. I thought deploying lean in a manufacturing environment, with production managers and operators very protective, territorial, and suspicious of change, was difficult. I can only imagine how difficult it must be as a lean consultant (especially one with no medical training) to come into a healthcare setting and start telling a bunch of doctors and nurses how to better treat patients. I feel a sense of why lean healthcare has not taken off the way it has the potential to.

Expectations

Yesterday I went to the eye doctor for the first time ever. The first order of business was to get my vision checked. Although I had never had this done before (except at the DMV) I had seen plenty of eye charts before and was pretty confident I could play the game. So when the chart appeared I confidently went straight to the bottom row and began rattling off the letter sequence. That is until I go to the very last character. I could see it just fine, but for some reason I could not for the life of me figure out what it was. The best I could come up with was a backward "S".

Finally, seeing me struggle, the medical assistant gave me a hint, "It's a number." Oh, a number! It's 2. A number! How dare they throw a number in there. That's the last thing I was expecting. The rules of the game I was playing said that you had to see and recognize the letters. It never occurred to me that there would be a number. So even an intelligent, literate person with perfect vision like myself could not immediately recognize a 2.

I think this illustrates the importance of understanding the game you're playing and making sure that you have not arbitrarily limited yourself by assumption, expectation, or preconceived notions.