Tuesday, May 17, 2011

The Human Factor in Healthcare

Several times recently, I've been asked by manufacturing folks about the challenges of making the move to healthcare as a lean coach.  The one challenge that I always emphasize is the human factor.  The human factor exists in every industry, but it's magnified in healthcare.  This is partly due to the manual nature of the work, partly due to to the fact that the product is the patient, and partly due to the unique cultural aspects of working in an organization that directly saves lives on a daily basis.

As a lean coach in healthcare, one must adjust both his or her expectations and tactics.

Adjust Your Expectations

Expect a lot of variation.  I mean a lot of variation.  Even with a calibrated, properly maintained, properly operated piece of machinery, we expect a level of variation.  Now take away the calibration, maintenance, and proper operation and see how much variation you get.  Now take away the machine altogether, replace it with a person, and see how much variation you get.  I could go on, but I think I've made my point.  Expect a lot of variation!

Adjust Your Tactics

As for our tactics, we must adjust them to take into account the human factors.  We have to design around the needs of not only the patient, but also the family of the patient.  We might have to make choices we don't want to make to accomodate the teaching needs of an academic hospital.  We have to define value in terms of not only the patient, but also of the payer.  There are so many layers of complexity that prevent us from getting to an optimal future state, but we can't let that stop us from moving towards at least a better future state.  We have to adjust our tactics and be much more agile.