Return to Previous Page

Quality Improvement in Healthcare: Can ‘Lean’ Lead the Way?

CASELET, HEALTHCARE MANAGEMENT
ET Cases, 6 Pages

Case Preview

Quality Improvement in Healthcare: Can ‘Lean’ Lead the Way?

It was a normal working day for Raghuram Prasad (Raghu), a software engineer in a reputed IT company in Hyderabad. While discussing about a new development in his project with his peers, he suddenly sensed a pinching pain in his lower left abdomen. Ignoring his pain, he continued the meeting assuming it normal pain due to  gastritis because of late night dinners and skipping breakfast.

As the pain persisted and increased Raghu was unable to bear the pain, hence he quickly concluded the meeting and shared about his abdominal discomfort to his colleague, Rajesh Kumar (Rajesh).

Rajesh: Did you ever have such pain earlier Raghu?

Raghu: Yes, a mild pain for a short time but not as excruciating and severe as today. I get intermittent pain, which is usually mild...........

Teaching Note Preview

Quality Improvement in Healthcare: Can ‘Lean’ Lead the Way?

Synopsis

This caselet enables a discussion in reducing the pre-operating stay of patients by applying quality tools and lean methodology. Hospitals are resource and money  intensive organizations wherein wasteful activities lead to additional costs and unnecessary stress to the patients and their attendants. It is essential that the hospitals have simple and smooth process flow (single piece process flow) eliminating waste (Muda)1 and loss of time, money and stress to the patient. Availability of Beds and  Average Length of Stay (ALOS) of patients in a hospital is one of the top most areas on which all hospitals, private or government concentrate on. In fact, ALOS is an  important indicator of efficiency for any hospital because maximum revenue is generated from the first 2–3 days of hospital stay of the patient in the hospital. Hence, the  need to focus and examine the prolonged pre-operative length of stay of patients and relook at the design and process flow of the hospital becomes more important.  Can hospitals take corrective actions to minimize pre-operative stay of the patient?

Prerequisite Conceptual Understanding (PCU)/Before the Classroom Discussion

This caselet requires an understanding of the basic concepts of quality management in hospitals/healthcare sector and a detailed understanding of quality control tools to reduce the prolonged stay of patients in the hospital. For that reason, the participants were asked to read the following chapters to help them to better connect these concepts to the caselet:

  • --Mark Graban, “Overview of Lean for Hospitals”, Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement, 2nd Edition, CRC Press, 2012
  • --S.K. Joshi, “Improvement of quality of services in hospitals”, Quality Management in Hospitals, 2nd Edition, Medical Publishers Pvt. Limited, 2014
  • --Mark Graban, “Value & Waste”, Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement, 2nd Edition, CRC Press, 2012

 

Case Positioning and Setting

This caselet can be used in PGDHM/MBA Programs for the following modules/topics in Hospital Management course:

  • --Quality Management in Healthcare – Improvement of quality of services in hospitals and Value and Waste – To understand the application of quality control tools and techniques in improving hospital processes, analyzing the problems, thereby removing bottlenecks and bringing continuous quality improvement
  • --Quality Management in Healthcare – Overview of Lean for Hospitals – To understand the concept of lean and its application in Healthcare/Hospitals to reduce the seven types of waste (Muda) and improve the efficiency


Assignment Questions

  • I. What are the various reasons for the prolonged pre-operative stay by Root Cause Analysis (RCA)? Brainstorm the root causes for the prolonged pre-operative stay and represent them using a Fish Bone diagram.
  • II. List the measures that the hospitals can take to reduce the prolonged pre-operative stay of a patient using Lean methodology. Explain the factors that are in control and out of control of a hospital using a Control Impact Matrix.
  • III. Discuss Muda (the different types of wastes) as per Lean Principles in a hospital. Identify and correlate with Raghu’s situations in this caselet.

 

Caselet Analysis and Classroom Discussion

Preamble to this Caselet Analysis

This caselet provides an opportunity to understand the challenge to healthcare providers in reaching the standards of patient care in a timely and cost-effective manner. It examines the different types of wastes, popularly known as Muda, and various factors responsible for prolonged pre-operative stay of patients in hospitals and stresses on the importance of eliminating waiting time at the hospitals. Accordingly, this caselet was discussed in the following way........


1 Muda is a Japanese word meaning “futility, uselessness” and is a key concept in the Toyota Production System (TPS) as one of the three types of deviation from optimal allocation of resources.

$3.37
Rs 0
Product code: HCM-2-0001, HCM-2-0001A

Abstract

This caselet can be used to discuss how the quality of patient care and hospital utilization can be improved by reducing the length of pre-operative stay of patients in  hospitals. Raghuram Prasad (Raghu), a middle-aged private employee was diagnosed with Acute Cholecystitis and advised to undergo a surgery. As advised by his  friends and peers he chose one of the best multi-specialty hospitals in Hyderabad for the surgery. Though the surgery was successful, Raghu left the hospital disappointed with regard to his prolonged stay in the hospital. This caselet examines the different types of wastes, generally known as ‘Muda’ and various other factors  responsible for prolonged pre-operative stay of a patient in hospitals and stresses on the importance of eliminating waiting time at the hospitals. Though lean  management principles have been used in varied industry verticals across the globe effectively, the healthcare industry is yet to witness its success. What could have  been the possible reasons for Raghu’s unhappiness in spite of getting treatment in one of the best hospitals? How can hospitals minimize length of pre-operative stay  by applying relevant quality control tools and lean principles? Taking corrective actions against such factors provide a provision for better and improved patient service  and satisfaction.



Pedagogical Objectives

  • To study and evaluate the factors/reasons leading to increased preoperative length of stay
  • To study the root cause for the increased preoperative length of stay by applying lean principles and other quality control tools
  • To discuss the different types of hospital wastes (Muda) and how they affect the work flow and patient flow in a hospital

Case Positioning and Setting

This caselet can be used in PGDHM/MBA Programs for the following modules/topics in Hospital Management course:

  • Quality Management in Healthcare – Improvement of quality of services in hospitals and Value and Waste – To understand the application of quality control tools and techniques in improving hospital processes, analyzing the problems, thereby removing bottlenecks and bringing continuous quality improvement
  • Quality Management in Healthcare – Overview of Lean for Hospitals – To understand the concept of lean and its application in Healthcare/Hospitals to reduce the seven types of waste (Muda) and improve the efficiency



This Case Pack Includes:
- Abstract
- Caselet
- Teaching Note (**ONLY for Academicians)
$3.37
Rs 0

Related Products

There are no related products to show here at the moment.




Request for an Inspection Copy

(Strictly for Review Purpose, Not to be Used for Classroom Discussion/Trainings)