(Snippets from the frontline)
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Everyone wants their hospital to run like a lean machine. Efficient, safe, and providing timely quality service. Some hospitals indeed are launching a “Lean” program to assure just that, by implementing a model devised by Toyota decades ago.
Business has taken over medicine and admittedly, it was not running efficiently. But can this assembly-line process be applied to patient care, or could it be detrimental especially if profit is the motivation in decision-making?
Some nurses are now being timed in their daily routines. Certainly, there might be areas where time is wasted. What if though they are micro-managed and told to spend less time with patients, quickening the process yet leading to the potential for errors and misdiagnosis? Of course, this can also be imposed on doctors who are employed by hospitals.
Interestingly, even though American hospitals are now using “Lean” in their facilities, no where in Japan have they used it in their own healthcare system.
Surely, “tune-up” takes on a whole different meaning.
Gene Uzawa Dorio, M.D.
In 1968 I was an RN whose “performance review” stated that I was an excellent nurse but I spent too much time with my assigned patients. This was in the day when your six patients were given bed baths! We stayed late to finish charting without pay and they wanted It to stop! I went into OR nursing after that!
A year ago I had knee replacement surgery and asked the night nurse if he could help me walk at 3 am. He told me “Yes, but I only can do it because I am mentoring a new nurse and have a little time.”
Things just recycle I think but the real issues never change!
You are of course correct! What your metaphor, comparing health care to the efficiency of Toyota , is that every Toyota is like every other Toyota.