Now that some sense of balance has been introduced into the world of Lean methods to improve production in Saskatchewan's health and education sectors, we now move into a period of assessment and adaptation that was perhaps missing earlier.
When the Lean practices were first introduced to the provincial health community, they required an almost obsessive, compulsive buy-in. Everyone had to be on board, or it simply wouldn't work. The leaders, and later the senseis who led the pack, were going to show health care professionals how to do their work more efficiently, quickly and effectively.
The government of Saskatchewan bought the package and served as the lead advocate.
It has come to pass that what might work in the manufacturing sector and assembly lines requires a whole lot of tweaking when applied to the health care assembly lines.
The question of how quickly someone or some team can perform a series of tasks, takes on an entirely new meaning when applied to patient needs.
"But wait, you can always stop the line," the care professionals were told, by the leadership who were clueing into the fact that perhaps line dancing wasn't the perfect model to follow when it came to treating fragile bodies and personalities.
So the conflicts began.
Do the workers take slower more methodical steps, or was there still the need to be quick and crisp?
Nurses and physicians began to question the methods and practises. The early cautionary signs were generally ignored. Those urging caution were dismissed as malcontents who just didn't want to buy in, at least not right away. But they would learn soon enough, that Lean was the truth and the way.
Then some patients, or clients we may call them, also started to question. The believers were trotted out to provide testimonials as to how wonderfully efficient Lean was. The detractors were not. Those who objected were listened to, and notes were taken.
The processes were tightened. Patients admitted on Monday could be discharged on Tuesday. If the patient needed to be re-admitted Tuesday night, the efficiency statistics didn't have to change.
Were all members of every health care team embracing Lean at all times?
It seemed as if the efficiencies had to be compromised when those not yet indoctrinated into Lean or substitute health professionals were injected into the team. How could they fit the established efficiency pattern? Were they part-timers or casual? What would the costs in time and funds be to train them if they weren't going to be there consistently? What about the health professional who learned one lean pattern in one facility but worked in four separate facilities?
Nurses began to relate tales of having to work under stopwatch mentalities. Patient transfers, they were told, need only take 30 minutes or less to process. Suddenly they found themselves in a relay race. They started to punch back.
Lean advocates insist that glitches are bound to happen, especially in the first two or three years as everyone becomes familiar with the program.
Lean initiatives began officially in Saskatchewan's healthcare community in August of 2012. Of the 44,000 health care employees who are, or will be influenced by the project, some have transferred or retired. Others will move in and out. It will be a moving target for the Lean practitioners who will most likely love the situation since it means their services will be required forever as long as they can keep selling the story, using Japanese terminologies, to lend some global intrigue.
