I just listened to Jim Womack's interview on Mark Graban's Lean Blog Podcast. Really good stuff, especially the part where Mr. Womack talks about healthcare. Here are the ideas/concepts that really resonated with me...
- Healthcare is not scientific. Mr. Womack says we think of the practice of medicine as a scientific endeavor, but when you go to the gemba of a healthcare organization, you often see a highly craft-oriented culture. Process variation between physicians is sometimes the norm, rather than the exception. The decision to perform a process differently is often not based on outcomes data, but rather on the way the process was taught to the physician by her mentor. Scientific, this is not.
- Physicians are the front-line workers. Whereas in manufacturing the "touch labor" employee might be an entry-level blue collar worker, Mr. Womack discusses that in healthcare this role is performed by highly-trained, highly-compensated physicians. This creates all sorts of unique situations that we must be aware of when trying to promote kaizen in a hospital setting.
- Nurses are the main ones thinking about process. When I came to healthcare as a newcomer less than a year ago, I was surprised that the nurses are pretty much the ones running the show, from a process perspective. As previously mentioned, the physicians are the touch labor employees. Mr. Womack indicates that his leaves the nurses as sort of the stewards of the horizontal flow of patients across our processes. Of course, nurses are also touch labor employees, so horizontal flow often gets pushed aside when the nurses have to focus on performing a touch labor task.
I highly recommend listening to the interview with Jim Womack. He talks a lot about his new book, his approach to walking the gemba, and other insightful tidbits. Check it out.