Intersection of Patient Safety and LEAN
I am often asked "How does LEAN relate to Patient Safety?" Both identify the "system" and the "teams" in which we all work as the key opportunities to improve and develop a sustaining culture of efficient and safe work. Systems determine performance and the improvement tools are the same regardless of the intended outcome- safe, efficient and cost effective working environments or safe, efficient and cost effective delivery of care.
The focus of both is to develop empowered, cohesive teams continually learning from workplace defects, educated in the use of strategies to improve performance in both domains of technical work and team work. Pronovost concludes that- "Individuals will always make errors, but teams can perform flawlessly." This is the call for work teams to be creative in redesigning their work systems to consistently attain excellence. To that end, as Robinson notes "Creativity arises out of our interactions with ideas and achievements of other people and prospers best under particular conditions, especially where there is a flow of ideas between people who have different sorts of expertise. Creativity flourishes when there is a systemic strategy to promote it." That last sentence should mean something to our leaders and managers as we focus on employee engagement.
Here is the Intersection of Patient Safety and LEAN as I see it:
- Cultural focus in the Patient Safety (PS) movement is on human performance and process improvement. This is similar to the cultural focus in LEAN on standard work, connections and pathways underlying continual process improvement.
- Behavior-based observations of work as it is actually done in both PS and LEAN inform of the opportunities for performance improvement.
- Involvement of the entire team from executive leaders and managers to staff members is key to generating and adopting ideas for improving processes in both.
- Blameless exposure of 'errors', defects and sources of waste by staff to become visible opportunities for change are reflected in Electronic Incident Reporting Systems (RadicaLogic) in PS and Visual
- Data Display posters and workplace white boards in LEAN work environments.
- Breakthroughs in PS and LEAN benefit from and are based upon the same quality improvement tools- root cause analysis, LEAN workflow design and work rules, focused six sigma or kaizen projects, mistake proof process and equipment design, process standardization, quality control checks, work barriers that stop defects from being passed as error precursors and PDCA scientific approach to change adoption.