Of all of the cost cutting measures to come barreling down the pike in healthcare, this latest one has to be the worst and most ominous. If fully implemented, I believe the individuals pushing this new workplace redesign concept will be at least partially responsible for the deaths of not only patients but the persons who care for them, namely physicians and nurses. I’m referring to LEAN Staffing.
If you aren’t familiar with the LEAN concept, allow me introduce it to you. The LEAN process, sometimes simply referred to as lean, is borrowed from the manufacturing sector. Lean production or lean manufacturing is a systematic method of identifying and eliminating waste within a manufacturing process. Well, that doesn’t sound so bad.
In essence, lean seeks to amplify or make obvious that which adds value to a product by reducing everything else which does not. This management philosophy was developed and utilized by the car manufacturer Toyota. So, how does this apply to humans? It doesn’t. That’s what makes it a bad idea for healthcare.
The actual application of this process to clinic or hospital staffing involves taking a process in healthcare, i.e. triage in the Emergency Department or nursing in a critical care unit, and breaking the entire process down into its constituent parts. Any duplication of effort or redundancy (in who’s eyes) is removed. Similar actions are combined (yet another loss of control). Shortcomings in personnel are either improved or removed (she/he is let go). Time allowances are shortened (you must work faster). Approved tools are prescribed then utilized and improper ones are discarded (by whom?). Waste (again, according to whom?) is eliminated.
The concise, but no less accurate, description for LEAN Staffing is “someone requiring someone else to do more with less.”