Hospital management to become lean and mean

Very soon, patients will not have to spend hours queuing up to see their doctor or waste their time waiting to be discharged - all thanks to the "Lean Manufacturing" principles.

The project, created in collaboration with the Institute of Hospital Quality Improvement and Accreditation (HA) and the Thailand Productivity Institute, will help hospitals reduce paperwork and increase productivity. It would even eliminate unnecessary documentation while discharging patients, said Dr Anuwat Supachutikul, a HA director who is leading the project.

Lean management is based on not wasting resources on anything other than serving customers. This management philosophy was initially used by the Toyota Production System, which cut down on the seven time and resource wasting sins - defects, overproduction, conveyance, waiting, inventory, motion and overprocessing - a decision that helped Toyota grow from a small company into one of the world's largest automakers.

Now, this process is being brought to the health industry.

Anuwat said the project - which began in June and will continue until November next year - is initially being tried out at Siriraj, Songklanagarind, Surat Thani, Saraburi's Sao Hai and Saint Louis hospitals.

Under the programme, hospital staff will be trained by Dr Kelvin Loh, a healthcare management expert from Singapore, who will evaluate the services offered, identify the processes that need to be eliminated and design a system that is both flexible and effective.

Anuwat explained that Thailand's healthcare industry faced problems in levels of productivity, the quality of services, and often the safety of patients was compromised. Besides, most hospitals, especially public hospitals, have limited manpower and have to cope with increasing workload.

Under the current process, nurses spend little time tending to patients and instead waste most of their working hours ploughing through paperwork.

To clearly identify and tackle waste in the healthcare service, lean management would focus on three areas -treatment, patient discharge and laboratory.

Loh, who also leads the Corporate Planning and Development Institute, National University Hospital of Singapore, said Thailand should focus on eliminating the patient load and reducing the unusually high numbers in public hospitals.

Local hospitals should look at how processes should be designed to meet patients' demands and enhance the quality of services instead of wasting money on new buildings or beds. He said he has been using this concept for two years and has discovered that it improves medical service and has even increased the number of discharged patients from 8 per cent to 50 per cent before noon - all from reduced paperwork.