Thursday, November 30, 2017

Waste

When experts talk about our country’s health care delivery system they usually begin by stating that the U.S. spends 40 percent more on health care per capita than any other country in the world. This is usually followed by the claim that a large amount of this spend is wasted on things that don’t actually benefit patients’ health.

This is a big statement, so let’s try to bring it down to the level of someone actually working in health care. What does waste look like to them? This morning I learned of a situation in our medical center. One of our employees collected information about a patient, loaded it into the electronic health record, and then printed out some of the information. This paper later reached a co-worker who scanned the information back into the very electronic system that it was originally printed from! (I suspect that this occurred because no one redesigned the work during the Epic implementation and it used to be going from one computer system to another). In the language of Lean production, this is called overprocessing and is one of the seven key wastes. The others are:
  • Overproduction (making more of something than necessary or before it is needed)
  • Production defects 
  • Movement or transportation (taking a material farther away from the process and requiring it to be moved back)
  • Inventory (the storage of overproduction)
  • Waiting
  • Unnecessary motion
The efforts of our colleagues who printed from a computer and then scanned the same information back into the computer were wasted. It added no value to the patient or to GBMC. I am sure that these colleagues were well-intentioned, but it raises the question of how many other tasks are being done that do not add value to the patient. Our people have so much to do that actually does add to the patient, but how much of their energy is spent on wasteful steps?

Our leadership system requires that our managers teach their employees about these wastes and empower them to test changes to our processes to get rid of waste. Lean Daily Management is just one tool to help eliminate waste. Value stream mapping and kaizen events are other tools that can be used. In the example of scanning information into the computer when the information is already there, we should just stop doing it!

I have a challenge for everyone in the GBMC HealthCare System. There are things that are scanned that do add value in healthcare, like outside medical information brought to us on paper or insurance cards, but are there things that we are scanning that don’t actually add value? Are we overprocessing this information? Please study all scanning and let me know what you find by commenting on this blog. Thanks! 

Holiday Decorations
Don’t the holiday decorations on our campus look beautiful?  I wanted to say thank you to Stacey McGreevy and her team for transforming our hospital into an eye-catching winter wonderland.

Let’s Fill Up The House!
This year, we are teaming up with WMAR-TV (ABC 2 – Baltimore) as a proud sponsor of the Fill the House for House of Ruth initiative to collect everyday necessities for this important non-profit organization. I am hoping that I can count on your help!

The House of Ruth provides services to nearly 9,000 women annually who are victims of intimate partner violence. Donations are needed to help women and children recover and rebuild their lives. The work that House of Ruth performs is aligned with our SAFE program. 

Earlier this week, various drop-off boxes (see picture) were set up throughout the GBMC campus including the GBMC Pediatric Group, Human Resources, Oncology Support, Spiritual Support, Volunteer Services, Family Care Associates and at each of our 10 off-site primary care locations.

All items donated must be new and unopened. The items of greatest need are:
--Diapers (all sizes) – House of Ruth uses 1,000 diapers each month
--Women’s and children’s undergarments – Underwear, bras, and undershirts (all sizes)
--Pillows, twin-sized sheets, comforters, and blankets

Other needed items include:

--Air mattresses
--Washcloths
--Gender neutral infant clothing
--Socks (all sizes)
--Children's coats
--Children's shoes

Another way to donate is through our Amazon Wishlist, where the most-needed items can be purchased straight from your computer. All items purchased through this Amazon link will be shipped directly to GBMC and then will be delivered with all the other items to ABC2 for distribution. 

Please don’t forget to donate at any GBMC drop-off location.You have until Friday, Dec. 15th! Thank you in advance for your generosity and Happy Holidays!

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