1. Conversation with Mark Graban, MS, MBA His Perspective on Lean Healthcare 1 In Conversation with…Mark Graban, MS, MBA [Personal interview]. (2015, 1). Spring 2015 ETM 568 Piedrahita, Borisov

2. Who is Mark Graban? “Mark Graban, MS, MBA, is an internationally recognized expert in Lean Healthcare, which has become one of the most popular paradigms for health care organizations seeking to improve performance and decrease waste. He has authored numerous publications about engaging health care workers in implementing Lean strategies.” 2 Spring 2015 ETM 568 Piedrahita, Borisov

3. Lean in Healthcare 3 ●Many aspects of an hospital are reminiscent of a factory. ●“Lean helps us to create workplaces with better flow, better safety, better quality, with lower cost as an end result. When you work together with nurses and other staff to design the workplace to be efficient, that workplace also becomes a safer and a more caring patient care environment.” ●When implementing lean in a hospital, its important to teach the lean principles and allow people combine it with the mission and values of the hospital. ● “Lean is trying to take these caring individuals and caring settings and making the hospital the best hospital that it can be by engaging people and managing differently.” Spring 2015 ETM 568 Piedrahita, Borisov

4. Change in Management Style ● Lean differs from the traditional top-down management model. It has a more participatory approach. The leader is a coach instead of a sole decision maker. ● 94% of the problems are due to the system, not the operator. ● “The best approach to quality and safety doesn’t come from punishment and retribution, but from understanding what we can about the system to prevent future occurrences” ● Conversations of what is wrong with the culture need to occur so that true change can be implemented and maintained. 4 Spring 2015 ETM 568 Piedrahita, Borisov

5. Patient Safety and Designing Systems The systemic root causes for errors and patient harm are normally fixable. Errors are normally preventable and tend to be repeated. Hospital should strive to improve their understanding of the human factors available. Initially, it will take more time to design the system, which can be also expensive, but the advantages in the long run will far outweigh the initial cost. “You go slow, to go fast” The testing time frame for the success of the system will depend on the size of the organization. 5 Spring 2015 ETM 568 Piedrahita, Borisov

6. New technology is supposed to make you more productive, not less productive. Implementing new technology without proper training of the personnel or failure to involve physicians/doctors into the design process can reduce the production and create more problems than the ones that already exist within the organizations. Healthcare has gone from largely analog to a largely digital industry. Technology should fit the way your people do the work. Its important to include physicians in the design of the new technologies. 6 IT in Lean Healthcare Spring 2015 ETM 568 Piedrahita, Borisov