Vladimir Sergeevich Veskochkovchief specialist of the Department of Higher and Additional Education of TsNIIOIZ, graduate of the program of the Ministry of Health of the Russian Federation and the state enterprise “Rosatom” “Leaders 1.0”, certified specialist in “lean production”, spoke about the introduction of lean technologies in the healthcare sector About the Lean Polyclinic project and why it is so important to follow the basic principles of Lean Technologies.
– Vladimir Sergeevich, how did you start your career in the healthcare system and why did you decide to study the topic of agile technologies in depth?
– In 2014, she graduated from Siberian State Medical University with a degree in Medical Psychology. Immediately after graduation, I started working in the department of clinical psychology, and after six months I also got a job in a hospital in my specialty. A little later, I was offered to participate in the Lean Technologies project and in a couple of days I leave for Moscow to study. While working in the hospital, I gradually proposed innovations that were important in my opinion, and some were implemented. Lean techniques made it possible to put such proposals on rails and turn them into finished projects. So I accepted the offer, and that’s how I began my studies of Lynn.
The training was conducted by the Russian Ministry of Health with the state. Rosatom Corporation. This is the same as Training 1.0, but at the time it was simply called Lean Leaders. The training lasted for a year, immediately after the first seminar we received projects in pilot clinics in the pilot areas. Subsequently, a Center for Lean Technologies in Healthcare was established, where we trained medical personnel in Lean Technologies and introduced Lean Manufacturing in medical institutions.
– What is the main principle and mission of introducing lean technologies in the healthcare sector?
– Traditionally, lean technologies were considered in relation to industrial enterprises, such as, for example, machine production. However, there is no doubt today that these principles and tools can work in healthcare no less effectively than any other industry.
One advantage of lean technologies in medicine is that they maintain a balance between patient expectations and the capabilities of the healthcare system. The main task of lean technologies in the healthcare system is to improve the process, reduce the time and cost of these processes, as well as increase the availability and quality of medical care.
– Many researchers use patient satisfaction with the quality and availability of medical care to assess the effectiveness of using BP (lean manufacturing) techniques. Do you agree with this point of view?
– If we are talking about such processes that affect patients, such as medical examinations or an actual doctor’s appointment, then by studying the opinions of patients, we can evaluate effectiveness through satisfaction. This evaluation is important along with criteria such as the time of the operation and the cost of its resources. It is important not to forget about employee satisfaction, which is also a key indicator, albeit an informal one. Lean technologies should not be forcibly introduced or personnel bypassed, it is important to understand the processes and be aware of their necessity.
– What key parameters can you identify to analyze the effectiveness of the application of lean technologies in healthcare?
– First of all, of course, this is the time for the operation and the satisfaction with it on the part of the patient and the doctor. Besides them, these are the material resources that the process consumes. In addition, I would like to note an increase in labor productivity: an increase in the number of patients, laboratory and diagnostic tests, a simplification of the discharge process.
– Since October 2016, the Lean Polyclinic project has been implemented in Russia. Since 2019, the project to introduce a new model for a medical organization with the transition to “lean” technologies has been part of one of the eight federal projects – the national project “Healthcare”. Please tell us about these operations and the success of implementing these projects in the country.
– In order to implement this project, specific evaluation criteria and guidelines were developed, taking into account regional characteristics and the characteristics of specific medical organizations.
Among the main criteria: reducing the patient’s waiting time for services, ensuring comfortable conditions for staying in a medical institution, a balanced distribution of functional responsibilities between doctors and nursing staff, optimizing flows, rational guidance of patients, eliminating all kinds of losses in operations.
Optimizing the process will have to be done in a complex way, and it must be admitted that each medical institution deals with this in different ways. It all depends on the training of the team, as well as on the initiative and attention of the leader, that is, the chief physician of the medical institution.
– Today, the termbased“Medication.” What is its basic meaning and how can we use this tool in practice?
– I would like to note that the name of the Lean Polyclinic project is more common. Lean translates only as “frugal”. Interestingly, you can find Japanese words like “Kaizen”, “Bye Yuka”, “Obe”Which is usually used without translation and means the desire to reduce costs and constantly improve the workflow in the hospital.
– Continuing with the modern terminology, please tell us about the implementation of the Six Sigma model, what are its main methods and tools?
More precisely, Lean Six Sigma is a process management method that focuses on the very rapid improvement of indicators such as customer satisfaction, in our case, patient, costs, quality and process speed. This is a synthesis of two popular trends: Japanese “lean manufacturing” and “sigma sigma” American However, it must be said that this method is more difficult personally, and in medicine it has not been used as widely as the lean techniques themselves.
The most common method in medicine is the 5C method, which in modern times can be found without simple techniques. The 5C system is a method of organizing the workspace, the purpose of which is to create optimal conditions for performing operations, maintaining order, hygiene, accuracy, saving time and energy. This method improves production culture and management potential in the work area.
– How can Lean Technology change healthcare delivery in the future?
The introduction of lean technologies will directly affect the quality of operations and patient interaction with the healthcare system. By applying lean techniques, we will get real results:
- reduce patient waiting time for services;
- standardization of treatment and diagnostic processes on the basis of “best practices” and reducing their diversity;
- Elimination of all kinds of losses in operations (waiting, unnecessary reports and accounting documents, unnecessary walking, marriage, etc .;
- Forming the competencies of Ministry of Defense employees to quickly identify and eliminate problems.
All of these factors will help the patient feel more comfortable in a medical facility. I would like to believe that thanks to the introduction of all modern projects, doctors will also work without fatigue, and their working procedures will be adequately and effectively organized.
– What books and articles would you recommend for a more in-depth study of Lean Technology in healthcare?
I recommend that you read two very important books that provide a qualitative set of background information on the topic of Lean Technologies.
First of all, this is a book. Taiichi Ohno “Toyota Production System: Moving away from mass production”. Taiichi Ohno is the creator of the Toyota Production System, which describes the evolution of the concept of lean manufacturing.
The second book is Lean Manufacturing in the Public Sector. How to create processes ”, edited by AV Ozarovsky and K. Tkacheva. It well describes the practical steps for implementing lean manufacturing, as well as the results of Russian and world practices.