Lean Management – Case Study of NHS UK
The value stream map to be used by the NHS would help in guiding the pathway of the patient from service users to the usage of supplies. ‘Patients’ are one of the significant customers’ of any Health care firms. Charron (2013) mentioned that lean management would help NHS to focus on the future state of actions needed to alter the system in which it currently operates. Patients will only be content by the availability of accurate services. Lean management policy will help the NHS to streamline the work processes, reduce costs and increase service quality. Below is the value stream map for providing accurate service quality to the patient’s:
Step 1: By involving the views of the patients, the authority would primarily define the value that the patient attains from each part of the process. The response would be mentioned at the top of the value map in order to direct future activities it meet the claims.
Step 2: Now, it is required to reverse the process of the patient’s journey. Fliedner (2012) referred that the reverse study of the patient’s journey will help in mapping the process in greater detail.
Step 3: Here, it is required to draw the journey of the patient from the starting point (for example, the referral and appointment). The latter specification would be placed on the left and the end point on the right hand side of the paper.
Step 4:Jot down each leap management procedure in the process box to indicate the flow of the process. Each of the process box should include the patient’s journey throughout their stay (Pezziardi, 2010). Each of the process box would stop at the time when the patient is waiting for the following stage.
Step 5:Herein the need is to join the individual steps in the journey of the patient. Each of the steps should be conjoined from left to right. The paths to be covered could be conjoined as follows:
Step 6:It is now required to analyse the accumulated data. Trent (2008) denoted that the current step helps in identifying the future potential of the service quality. It is thus required to include a data box below each process with relevant measured data allotted for each of the steps. For detailed measure of the current policies, the time measurement should be consistent. The results will thus beaccurate and strategic future policies could be built in order toovercome the current flaws.
Aherne (2007) identified the common system measurements include: value added time, changeover time, number of people, availability of working time and determination of lead time. Future policies will depend on current process of time measurement.
Step 7:Herein, the measure would include the identification of the number of patient’s waiting for the next process and the time it takes to offer services to the patient. Doing so will help to identify the total time taken in offering services to the patient’s. The current process has been illustrated underneath:
Step 8:The current step is to determine the information flow. In each of the steps it is necessary to consider the current information that is provided, the source of data. Doing so will better the value stream process.
Step 9: Herein, the need is to identify whether the patient is ‘pushed’ through the journey or ‘pulled’ along the pathway. Bahensky et al. (2008) stated that the patent flows to the next level. See below to identify the nature, if flow from a certain level to the next level:
Step 10: Herein the final time taken in completing the study will be evaluated. A time line at the end of the page will be set.Each process will have a waiting box that denotes the total lead time taken in order to deliver the service. The final step thus incorporates the task of completing lead time of the entire journey along with the value added time.
2.0 Lean Management:
Lean management is a supporter of continuous improvement. Ballé and Regnier (2010) denoted that lean management is basically a long-term systematic approach that is employed with a general aim of achieving small and incremental alterations in the operational processes in order to improve efficiency and quality. Contrary to the latter definitions, Endsley et al. (2006) mentioned that the goal behind practising lean management is to attain highest quality services at the lowest cost. Effective lean policies help firms to maintain a short lead time, best safety and high staff morale. Besides experiencing operational stability, businesses’ practising lean management structure can en be able to standardize its work.
Fillingham (2011) denoted that lean management focuses on eliminating waste such that each of that, each of the activities provides customer values. Although, the current concept is mainly fitted the manufacturing units, it can be applied within the health care organizations. Herasuta (2012) mentioned thatin case of health care firms, the care workers should rely on multiple and complex process to accomplish their task, thereby, offer valued offerings to the target mass.Applying lean management in healthcare firms like the NHS would include the task of providing value to the customers’ or the patient. Holweg (2007) denotedthat the normal wastage in healthcare firms’ occurs normally when the current offerings do not meet the customers’’ expectations. In case of not meeting the patients’ expectations, the NHS would experience a loss in money as a result of improper investments behind the services. Money, time and goodwill will decrease as a result of not practising lean management. Jimmerson et al. (2013) also added that practising lean management will benefit the entire organization by having a positive influence on productivity, cost, quality and timely delivery services. If required, the care firms could train its staffs in a manner such that the current and future care policies can be met. However, Kaplan and Patterson (2008) acknowledged the significance of diagnosing the environment in order to detect current care needs of the patients. The market research will help the NHS to alter its operational policies in a manner such that the care workers are able to treat the patients in a manner such that their desired service expectations are met. The faster the service level, lower will be the dissonance rate. Lower dissonance rate would thus help in increasing the productivity level and revenue earnings of NHS.
2.2 Principles of lean management:
The lean management process follows certain principles for its effective functioning. In the primary stage, Panchak (2008) signified the importance of offering specific value from the standpoint of the end customer. Doing so is considered to be helpful for NHS to detect the specific steps in terms of care delivery that are frequently in-demand by the customers. The NHS could even identify the services to be generally demanded by the product family.The next principle includes the task of identifying the steps in the value stream for each of the product or service set. Pettersen(2006) responded that the current step of lean management is crucial as it eliminates the activity that is considered to be not creating value. Identifying the same will help in involvingnecessary, valued offerings that would satisfy the service needs of the patients’.Eventually, the same would help in recovering the wastage instead lower production cost. Doing so will help the NHS to increase its sale by dedicated and profitable offerings. However, Radnor and Walley (2008) mentioned that it is required to maintain a flow such that product flows smoothly towards the consumers’. In case of hitch, the current care services will no more be attractive to the customers; instead they will prefer to switch over their preferences. The flow of product will ensure that the customers’ determines the positive merits of using the current service and develops an urge to experience the current offerings of the NHS. Silvester et al. (2005) denoted that with the introduction of the flow, the customers should be allowed to pull value from the next upstream activity.However, the current offerings should be tight enough to motivate the customers’ to advance themselves in the value stream. The current valued offerings of the NHS will influence the customers’ to access its services instead of ‘pulling’ out. The final step incorporates the process of redirecting the lean management principles until a state of perfection is reached. By attaining the state of perfection, NHS would be able ensure that perfect value is created without any waste. Soon the patient’s will be content with the current offerings and the NHS would be able to experience desired success from lean management practices.
2.3 Operational benefits from application of lean management principles:
Sirio et al. (2010) mentioned that lean management helps in eliminating wastes throughout the business process and stresses on including effective strategies that would meet the desired product or service preferences of the customers’.Firms’ like the NHS would experience the under mentioned operational benefits with the application of lean management principles:
- Better quality and fewer defects:
Sirio et al. (2010) mentioned that narrower focus on the delivery of effective services delivery would result in customer satisfaction and reducing wastage. By focussing on the exact service needs, NHs would only strive to care patients as per their satisfaction level.
- Improves staff morale:
Spear (2011) identified thatthe training procedureshelps in improving the morale and satisfaction level of the customers’. Satisfied staffs will be motivated to offer services that will meet the demands of the customers. While in one hand, the productivity level of care workers’ will improve, the service expectations of the patients’ will soon be met.
- Higher Profit and lower cost:
Tucker and Edmondson (2014) responded that lower wastage and wider service accessibility will result in higher profit. The NHS will soon be able to meet the expected service preferences of the customers’. Although, it is not possible to meet the exact preferences of the entire mass, yet lean management policies will help to lower service delivery cost and earn higher profit from wider customer satisfaction.
However, Westwood and Silvester (2013) determined that success of lean management is dependent on the commitment level of the workers. Also, the revenue earned from the individual application of the tools is only effective for a short time span. Nevertheless, the current concept is effective for the purpose of effective service delivery.
2.4 Significance of lean management in the next five years:
By dedicatedly following the lean management principles, the NHS could specifically forecast the productivity level, service turnover and revenue to be earned. Future projects could be planned in an effective manner such that and its returned could be accurately pre planned such that the return meets the expectations. In the coming 5 years, the lean management policies could be applied by NHs in order to identify the distinct service demands of the patients’. Future strategies could thus be developed in order to meet the forecasted service demands.
3.0 Impact of lean management to improve value stream
Before analyzing on a particular project, the management of a particular organization requires to compare the potential benefits to the coast. Thus, lean management is efficiently important to outweigh the costs that are incurred to implement during the planning process (Charron, 2013). So has been the case of NHS, one of the top most health care industries in UK, has undergone the sub standard process and has created a medical negligence in the compensation claims. Pezziardi (2010) mentioned that medical negligence compensation claims is a complicated area of law, therefore, the management of the hospital needs structured advices from the recognized expert before taking any unified decision. However, the medical care standard provided by NHS fell below the expected professional level. According to Aherne (2007), quality care cannot be achieved by concentrating only on the aspects of quality handling, whereas, the department needs to uplift the professional standards of the health care policies. On the other hand, Fillingham (2011) have gone through a thorough study where the patient perceiving the service from the particular hospital have raised numerous claims against the time management of the doctors.
Therefore, Herasuta (2012) suggested that in order to repair the negligence the management of NHS has to undertake an effective lean management where the solicitor requires coming up with advisable strategies in the relevant medical field. However, the medical experts review on the medical records and needs to introduce the system of medical examination before the final report of the patient.
Moreover, the maximum number of patient argued that even though the administrative department and medical practitioners tend to admit the negligence, but the administration fails to repair on the damages caused due to the negligence (Kaplan and Patterson, 2008).As a result the reputation of the particular hospital seeks to diminish and due to the negative word of mouth, the brand seeks to experience a slaughter in the client base. Therefore, here the management needs to strategies on the policies and need to analyze on the later effect of the negligence. On the contrary, Panchak (2008) argued that often the solicitor is responsible for the causation of the problem due to the lack of seniority. Due to the overall standard of the organization hampers.
Thus, in order to repair the damage caused by the team, the admin department needs to improvise on the lean management and emphasize on the preferences of the patients and the overall health care department, by introducing special services and maintenance team. Spear (2011) suggested that the amount of damages depends on the various factors, amongst which the most important is the suffering of the patient and the financial loss incurred by the family members. As a result, the financial department of NHS requires coming out with effective and structured layout, as the compensation and claiming against NHS health care institute is comparatively high. In case of any wrong financial decision, the overall proclamation of the health care institute can seek to incur a huge loss.
4.0 Cost-benefit analysis of NHS:
As mentioned in the previous section that the downturn of the service quality and negligence of the corresponding customer services is the key issue arisen in NHS. The reason behind the issue could be lack of adequate infrastructure and equipments or lack of sufficient knowledge regarding the treatment. In order to address the issue lean management could help to reduce the unnecessary cost factors from account for better operational efficiency.
Cost-benefit analysis is one of the potential instruments judging the benefits of the projection of mitigating the issue arisen in NHS. From the reports of the participants, it has been obtained that reduction in use of NHS services could improve the physical health. In that case, the survey demonstrates the reduction in number of GP visits where the 50% states the reason of the same due to the issue. The valuation = 300×50%x£36×3 less visits per year = £16,200
On the other side, the cost of waiting for patients has figured out to be £100 a month that could be used to quantify the benefits. Therefore, the lean management could maximise the benefits from the projection through minimising the cost factors that could effectively address the concerned issues arisen.
Aherne J. (2007). “Think lean”. Nursing management, 13(10): pp.13-15.
Bahensky, JA. Roe, J. and Bolton, R. (2008) “Lean Sigma—Will It Work for Healthcare?” Journal of Healthcare Information Management ;19(1):pp. 39-44.
Ballé, M. and Regnier, A. (2010) “Lean as a learning system in a hospital ward”. Leadership in Health Services;20(1): pp. 33-41.
Charron, R. (2013). The lean management systems handbook. Boca Raton, FL: CRC Press.
Endsley, S., Magill, MK. and Godfrey, MM. (2006) “Creating a lean practice”. Family Practice Management ;13(4):pp. 34-38.
Fillingham D. (2011) “Can lean save lives?” Leadership in Health Services. 20(4):pp. 231-241.
Fliedner, G. (2012). Leading and managing the lean management process. [New York, N.Y.] (222 East 46th Street, New York, NY 10017): Business Expert Press.
Herasuta M. (2012) “A Lean Laboratory”. Laboratory Medicine. 38(3):pp. 143-144.
Holweg, M. (2007), “The genealogy of lean production”, Journal of Operations Management, 25: pp. 420-437
Jimmerson, C., Weber, D. and Sobek, D. (2013) “Reducing waste and errors: Piloting Lean Principles at IHC”. Journal on Quality and Safety ;31(5):pp. 249-257.
Kaplan, G. and Patterson, S. (2008) “Seeking perfection in healthcare. A case study in adopting Toyota Production System methods”. Healthcare executive. 23, pp. 16-21.
Lilford, R.J., Dobbie, F., Warren, R., Braunholtz, D. and Boaden, R. (2008), “Top rate business research: Has the emperor got any clothes?”, Health Services Management Research, 16(3),:pp 147-154
Panchak P. (2008) “Lean Health Care? It Works!” Industry Week.;252(11), pp. 34-40.
Pettersen J. (2006) “Defining lean production: some conceptual and practical issues”. The TQM Journal, 21(2):pp. 127-142.
Pezziardi, P. (2010). Lean management. Paris: Eyrolles – EÌd. d’organisation.
Radnor, Z. and Walley, P. (2008), “Learning to Walk Before We Try to Run: Adapting Lean for the Public Sector”, Public Money and Management, 28/1, pp 13-20
Silvester, K., Lendon, R., Bevan, H. R. S. and Walley, P. (2005), “Reducing waiting times in the NHS: is lack of capacity the problem?”, Clinician in Management, 12/3, pp:105-111
Sirio. C, Segel, K. and Keyser, D. (2010) “Pittsburgh Regional Healthcare Initiative: a systems approach for achieving perfect patient care”. Health Affairs., 22(5):pp. 157-165.
Spear S. (2011) “Fixing health care from the inside, today”. Harvard Business Review ;83(9):pp. 78-91.
Trent, R. (2008). End-to-end lean management. Ft. Lauderdale, FL: J. Ross Pub.
Tucker, A. and Edmondson, A. (2014) “Why hospitals don’t learn from failures: Organizational and psychological dynamics that inhibit system change”. California Management Review. 45(2):pp. 55-72.
Westwood, N., and Silvester, K. (2013) “Leaning towards efficiency”. Healthcare Finance Magazine. 12, pp. 13-16.