Lean Healthcare Deployment and
Sustainability
Chapter 10: Standardize Best Practices
Sydney Herrin
PDCA (p. 87)
Planned
 Done
 Checked
 Act




Eliminate Barriers
Ensure there is a stable Quality Management
System (QMS)
Ensure that new and improved processes are
hardwired
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What is a Stable System? (p. 87)
Consistent adherence to well-defined
policies and procedures.
 Two pieces:




Policies and procedures exist
They are followed
ISO 9000
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Example: Operating Room Turnover (p. 89)
Average: 93
minutes
 Significant daily
variation
 Points outside
control limits
 Out of control

Source: Dean Figure 10.1 (System out of control)
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Example: Operating Room Turnover (p. 89)
Average: 87
minutes
 No points outside
control limits
 More stable and
predictable
 In control

Source: Dean Figure 10.2 (System in control)
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Example: Operating Room Turnover (p. 90)
Average: 46
minutes
 Average
significantly
decreased
 Narrower control
limits
 Improved

Source: Dean Figure 10.3 (Improved system in control)
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Successful Improvement Requires a Stable System (p. 91)
Source: Dean Figure 10.4 (Relationship between a stable system and process improvement)
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How Do I Do It? (p. 91)

Step 1: Eliminate Barriers


Identify during transformation support meetings
Ensure an environment of open and honest
inquiry
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How Do I Do It? (p. 92)

Step 2: Ensure There Is a Stable QMS

Infrastructure



Corporate office headed by executive reporting to
CEO
Sufficient support staff
Quality Management Council
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How Do I Do It? (p. 92)

Step 2 cont.

Quality Management System






Documented policies and procedures
Structure for reviewing and updating policies and
procedures
Internal audit system
Rigorous training and development program
Corrective and preventive action system
Continual improvement component
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How Do I Do It? (p. 93)

Step 3: Ensure That New and Improved
Processes Are Hardwired

Ongoing review and oversight to ensure






QMS documentation is continually updated
QMS is responsive to external requirements and
internal improvements
Work instructions are developed, documented, and
updated at process level
Policies and procedures are developed, documented
and updated at the healing pathway level
New opportunities are identified and implemented
A culture of continual improvement
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Case Study: Healing University (p. 93)

CEO, Will Patterson



“We have to define the way we are going to do
things, and ensure consistent adherence across
the system.” (p. 93)
“The more we can improve the quality of care
and do so at a lower cost, the better we will be.”
(p. 93)
The Healing Way
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GLOSSARY
Stable System (p. 87)
A system in which there is a consistent adherence to
well-defined policies and procedures
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References / Contact Information
Dean, M.L. (2013). Lean Healthcare Deployment and Sustainability.
New York, NY: McGraw Hill.
Contact Information:
Sydney Herrin
[email protected]
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