The Use (Or Misuse) of Lean Terminology in Healthcare

Flow
There are countless Flow Co-ordinaters and Flow Managers in Healthcare, but all we actually witness, really, is movement not flow. Sure we may out lie patients, for example, to accommodate incoming patients. At face value this may look like flow at the front end of the hospital but from the patient who has just been outlied’s perspective it certainly isn’t Flow.

True Flow is still the holy grail for even the most advanced lean organisations in any industry and even then it usually only occurs very briefly. Which is why we need Pull.

Pull
How often do you hear “we’re going to pull a patient from MAU to a ward” when a bed becomes available. That’s really saying we’ll accept you onto our ward now that we’re good and ready for you – that’s actually push as far as the patient is concerned.

You cannot pull the customer. The customer pulls our services. It’s our job to help the patient (the customer) to pull themselves through the system providing whatever they need, safely, in the right quantity, whenever they need it.

Lean
Even the word lean itself is grossly misused. “We’re going to lean out the number of staff in ED” for example. Not a good way to win over converts to lean.