Pretty much every guy feels the need to own a disgustingly over-powered set of wheels at least once during his lifetime. Perhaps before the kids and tan minivan or as a reward for surviving the kids and tan minivan. In my case it was to learn about the issues of velocity and the lean supply chain… ok ok maybe it was that narly winding shortcut from the central California coast through the vineyards that I take to the office most days. It definitely perks up the brain cells in the morning and helps leave work behind in the evening, although cleaning up the spilled coffee is becoming annoying. Effective cupholders were apparently not a design priority.
An article on lean healthcare?
Yes, sandwiched between an article on the new 520hp Cayenne Turbo S and rediscovering Hemingway’s Key West in a Boxster, was a story on "value creation in medical science… first aid in process optimization… lean process improvement." Of course there are photos of a very sweet 911 sitting in front of the hospital, but there’s still some decent meat.
Porsche Consulting worked with the Freiburg University Hospital to improve the cardiovascular surgery unit. I did some poking at "Porsche Consulting", and it appears it was born in the 1990’s following a "successful restructuring at Porsche"… perhaps the guys that didn’t have an auto-related job after the restructuring and didn’t show the required acumen for designing pens and sunglasses? Actually I shouldn’t be so harsh as their talents and efforts apparently paid off at Freiburg.
Although the writing is a little over the top ("the employees at Porsche Consulting are quite fearless…"), it is a good read on adapting lean thinking to healthcare… and healthcare in Germany no less. And a good heads up for those who advocate euro-style socialist healthcare… a funding gap of 60 billion euros between payments and costs, extreme financial difficulties at hospitals with some of them starting to reduce technology, and ever-lengthening wait times for even basic surgeries.
The doctors had to deal with their life-saving bypass and heart-valve operations being degraded to mere "value creation" during extensive value stream mapping activities. The consultants spent several weeks at the gemba accompanying the specialists and support staff on all shifts. There were two fundamental observations that led to significant changes: the lack of clear clinical pathways and the lack of defined patient management. A lot of time was spent trying to figure out where patients needed to be, which was aggravated by numerous functions having the authority to admit patients.
Clinical pathways were clarified through the use of standard work methods, which resulted in the creation of OR checklists and patient routings. Patient management became the responsibility of the new Patient Manager position, who alone is authorized to admit patients. This function has access to occupancy schedules, bed availability, surgeon schedules, and comprehensive patient data.
The results include a reduction in average patient stay from 11.4 days to 9.6 days, unnecessary idle time trimmed by 10%, and productivity increased by 30%. Not too shabby for a couple weeks of effort. That’s the power and magic of lean (with apologies to Norm Bodek)… just when you think there’s no way to improve costs and efficiency… you can achieve 30% rather quickly. Anywhere… not just manufacturing.