I am frequently asked by staff and members of the public why I am supportive of Lean. In order to best answer this I need to look back over the 20 years I have been involved with health care.
When I started out as a nursing student in the early 1990’s, I heard a lot about a crisis in the health care system and its unsustainability if we did not do things differently. During the time that I worked as a Registered Nurse it was unclear what this crisis really meant to me and my colleagues other than the likelihood that less money would be available to deliver services in the future. My role as an RN seemed to be far away from any meaningful action when addressing these systemic issues in health care.
As I moved into a management position in 2004, I was intrigued by what I could potentially do in this role. What I found, was that it was very difficult to address change as a manager. Staff did their work well; they cared for patients and clients, but often felt that the financial and service delivery issues were the problems of their manager to address. I will readily admit that in my early years as a manager I was not terribly effective in driving significant change, but simply supported staff in continuing with the status quo of services.
When I came to Mamawetan Churchill River Health Region, I started learning about Lean. The Province was beginning to take tentative steps which they later formalized into the Saskatchewan Health Care Management System. This model for change struck me as a positive way of making changes that was very different from the approaches that I had used before. The model placed the patient as the central customer of the health system and focused on providing value to them. It also recognized that the staff closest to the point of care to our customers are best situated to see where this value can be achieved, not the manager.
As a Health Region we are in the very early stages of a long-term process to refocus our model on how we can better meet the needs of patients. Each department will be working on actions that potentially will bring about better value for patients and their families. Some of these actions will be about improving safety for patients and staff, some departments will remove or improve paperwork or processes that serve little to no purpose, and others will look at how we can best utilize the mix of skills that staff in a department have to better meet the needs of patients.
In order for these processes to be successful there are significant changes to be made. Perhaps the most significant is for the managers, directors, and me to adjust our approach to providing support to readily allow staff to address the areas where we are not providing value to patients. To do this each department will be developing Daily Visual Management walls and have daily or weekly meetings to look at the processes that are used and to identify and measure the actions for improvement that are agreed on.
In order for these processes to be successful there are significant changes to be made. Perhaps the most significant is for the managers, directors, and me to adjust our approach to providing support to readily allow staff to address the areas where we are not providing value to patients.
When I look back over the 20 years I have worked in health care, I wish many of these processes had been in place when I was a nursing student. I think that the issues I saw as a nurse and as a young manager, but felt unable to address, could have been effectively managed to the benefit of our patients through using the skills of staff. This is why I am excited and passionate about the development of Lean in MCR.