Going to the gemba: healthcare supply chain’s lean transformation

Created for the manufacturing sector in Japan, Lean Process Improvement is a philosophy and a set of tools that can help organizations optimize their performance. In the last 30 years, Lean has become ubiquitous in multiple industries beyond manufacturing, such as grocery and retail. Now it is increasingly finding its way into healthcare, with numerous converts touting its benefits.

One of the most important features of Lean, according to Suzi Collins, director of materials management at Mountain Vista Medical Center in Mesa, Arizona, is the concept of going to the gemba—a Japanese word that means “the actual place.” Simply put, Lean emphasizes the importance of viewing a problem from the ground level. In manufacturing, that would be the factory floor; in healthcare, it could be the nursing units or the warehouse.

Traditionally in healthcare, decisions have been made at the c-suite level. No matter how good the data may be, without real world context, it can be difficult to appropriately react to it. By visiting the site of the problem, leadership can gain a deeper understanding of the causes and be more enabled to design solutions. Sometimes, organizations will take this kind of micro-level look when investigating a negative event, but, Collins said, organizations can benefit from employing this technique proactively.

Before joining Mountain Vista, Collins was a consultant, interacting with numerous organizations and privy to their pain points. And she noticed a common theme: Organizations knew they had to make a change but did not know how to implement the change while continuing to function in their day-to-day operations.

Lean assessments can help ascertain the steps and bandwidth required to balance new project needs with daily needs. In some cases, an outside consultant with a background in Lean can act as a facilitator, keeping the project moving forward without having to attend to other duties. Facilitation is distinct from typical consultation. The latter tends to focus on diagnosing an issue, but does not necessarily participate in the process to address that issue. Facilitators, particularly those with a Lean background, work as members of the team.

Collins suggested that when organizations decide to implement Lean strategies, they should start small. A fundamental mistake Collins has seen at numerous hospitals around the country is the tendency to start with very large projects and become frustrated when the projects fail. However, by starting small, they can gain the knowledge, the experience, and the belief that Lean is going to make a difference.

“To me, the ultimate fit of Lean in healthcare is with supply chain,” Collins said. “Because if we‘re doing what we‘re supposed to do in the best possible way, it reduces so much rework in the procedurals areas.”