Thursday, November 3, 2011

Curing What Ails Our Hospitals

By Al Norval

I read this article in a recent issue of Fortune magazine and have to admit it was the catchy title that caught my interest. "Curing What Ails Our Hospitals” went on to talk about a new design for hospitals that dealt with three problems that afflict most current hospitals. That is:

Energy Efficiency
High Cost

The article stated that infections were the leading cause of death in US hospitals.

In a play on words, the article quoted Norman Cousins saying that “A hospital is no place for a person who was seriously ill”.

I think that one line summarizes the state of Healthcare in North America.

Rather than just stating the obvious, the authors did offer several countermeasures. I’ve summarized the approach this way – improving the quality of patient care by reducing hospital induced infections will result in lower a length of stay for many patients. A shorter length of stay translates into savings and improved patient (Customer) satisfaction. Combine that with energy efficient buildings and a focus on prevention using team based care and the costs of healthcare can be brought back into line. Makes sense to me – I’d be interested in your opinions.

Their ideas for team based care included small neighbourhood hospitals which sounded a lot like SMED and small lot size needed for flow. Flow occurs in the absence of waste and I could visualize many waste reduction ideas in their design. Having the doctors, nurses, pharmacists, and others involved in patient care work as a team eliminates many forms of waste and more importantly allows the team to problem solve quickly and efficiently.

It all comes back to the basics of Lean:

Eliminate waste
Focus on the Customer
Engage team members in problem solving

By doing this, costs will take care of themselves.


  1. Very interesting Al. Boiled down towards great clarity of gap.

  2. Great post, Al -- thanks!

    Team-based care concept is especially powerful. One of my favourite assignments at Toyota was applying Lean in our Health Center. We had 20 team members including nurses, doctors, occupational and physical therapists, and an ergonomist.

    And we had a city, in effect, of 3500 team members doing the challenging of making cars.

    Our countermeasure?

    Team-based health care, wherein specialties worked in teams, each with a case leader. The results were remarkable and a source of pride to this day.