"The Ronan Report" provides insight about the activities at the Western Maryland Health System in Cumberland, Maryland, and about the changes taking place in healthcare today from a CEO's perspective.

Monday, November 23, 2015

Is the Juice Worth the Squeeze?

Last week, a group of us from WMHS had the opportunity to visit a health system out of state that is doing what they describe as some amazing things with process improvement.  They have been involved with applying the Toyota Production System (TPS) since 2002 at their facility.  To this day, they take teams of their people to Japan annually for two weeks to study the Kaizen method of continuous improvement to eliminate waste and inefficiency.

In 2012, WMHS ceased our Lean Six Sigma efforts, a similar approach to process improvement, since the philosophy never really got any traction system wide.  We had so many competing priorities with transitioning to the new hospital and changing our care delivery model from fee for service based on volume to a care delivery model based on value (TPR).  Some areas at WMHS continue to use the Lean Six Sigma process improvement approach, but it is not applied throughout the system.  

The reason for the visit is that we want to re-engage our approach to process improvement, but as it applies to improved quality and care delivery.  This particular health system has dedicated their existence to TPS and it has worked in ensuring greater efficiency and eliminating waste.  What it hasn't done is dramatically improved quality, patient safety or even the overall patient experience as one would expect.  For the commitment of time and resources, one would have anticipated a much greater direct impact on the patient.  

They claim to be much more efficient, but it wasn't obvious when you toured their hospital and saw their outcomes.  It was apparent to me that "the juice hasn't been worth the squeeze," if you will.  They have committed millions of dollars and considerable resources each year for the last 13 years, including human resources, to this effort and yet they appear to be just like any other hospital with above-average performance in those areas that truly count: quality, patient safety and patient satisfaction.  

Sure they stand out in some areas as do most of us, but we have not spent millions of dollars year after year in being above average.  Quite honestly, I was expecting stellar performance in HCAHPS, clinical performance, US News and World Report rankings, core measures, hand hygiene and the list goes on.  But it wasn't there.  In fairness, there were a number of approaches that our team found useful for application at WMHS, but the effort and the commitment just didn't seem worth it.  Our journey will continue and I will keep you posted through future blogs.

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