are giving Lean a bad name by inappropriately labelling their own efficiency drives as Lean drives, many have enjoyed great success.
“If you consider how the Royal Hospital in Bolton have approached the use of Lean, you see that is systematic in aspect of their work and there is clear engagement with the methodology by their board and throughout the organisation.
“Although the original ideas were produced through holding workshops, the overall approach has been to maintain a sustained programme which is well resourced and present through the organisation, rather than some hospitals which have what are called ‘islands of excellence’ where perhaps a particular ward has done something. After a while these kinds of initiatives tend to fizzle out.
“An issue which seems to crop up again and again is that whilst frontline staff might be engaged in a productive ward or productive operating theatre programme, the senior management have not been savvy enough to link that work up with other Lean programmes taking place within the same trust. They just don’t seem to make the connection and realise that they need to engage in a joined up, culture changing approach.
“This leads well into what I consider to be the five key success factors in implementing Lean, the first being the acknowledgement that organisations in implementing Lean means changing their culture, rather than just focusing on the tools. Most of the implementation which I have seen within the NHS has been more based around the tools which organisations are using to effect change rather than changing the culture.
“To do this you need ‘buy-in’ Sep/Oct 10
organisation are trying to achieve, how Lean is being used and what the purpose of it is.
at all levels, which leads to my second factor, which is the need for commitment from the most senior management. When I visit a site, once I have interviewed the chief executive and chief operating officer, I can quite accurately predict what the frontline staff’s reaction will have been to Lean. This leadership is essential and when good leaders move on, it can cause real problems to the programme.
“The third factor is around communication and effectively letting your staff know exactly what it is that you as an
“The fourth point is then around resources because it costs a lot of time and money to implement these things properly. I feel that now hospitals are beginning to realise that a proper Lean transformation needs to be resourced properly. Trying to achieve it on an inappropriately small budget and in isolation just isn’t going to work.
“The fifth point is about the notion of ‘readiness’, as I call it, which means creating an understanding of the other factors which I have mentioned into account, but then also considering the capacity and demand and matching that to the resources which you have available, what the process is and most importantly what the ‘value’ is you are delivering to.”
nhe 17
Just because
an organisation engages in a few ‘rapid-improvement’ events, doesn’t mean that they have used Lean as an improvement tool to improve quality, rather just to cut back on low hanging fruit. I think that this is where Lean sometimes gets a bad name
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