patient care is mostly about the delivery of treatment with the overall goal of
wellness and an improved quality of life, there is a business aspect that
cannot be ignored—and when it is, oftentimes patient satisfaction and
efficiency deteriorate, making the overall goal unreachable.
gaps in this is what led Franklin Smith, MD, clinical director for the
University of Cincinnati Cancer Institute and pediatric oncologist specializing
in hematologic malignancies, or blood cancers, to seek a solution for cancer
care within the institute.
saw major problems and a need for Lean training among faculty and staff,” he
involves a set of practices that originated in the business world and are based
on the assumption that customer satisfaction is achieved by identifying and
eliminating or reducing all activities that do not create value for the
end-customer. These practices were first organized by Toyota into a management
philosophy called the Toyota Production System, but they have been used
successfully to drive customer satisfaction initiatives in financial services,
banking and health care.
about customer—or in this case patient—satisfaction,” Smith says. "In 2011, UC
Health didn’t have the resources necessary to monitor and correct certain
aspects of cancer clinical care from the operations stand point. I went to Vice
President and Chief Operating Officer Nancy Barone with this, and she suggested
that I get in touch with Rajan Kamath, PhD, from the UC College of Business.”
associate professor of strategy and international business with the department
of management at the Carl H. Lindner College of Business, who has published
award-winning Lean research in the Harvard Business Review, had just created a
class about the use of Lean practices in health care for graduate students at
"With the Lean model, the two main goals are customer satisfaction and process
analysis to improve both efficiency and effectiveness. Health care is the most
recent context for the application with these cross disciplinary needs, leading
to the creation of a new class for MBA students about strategy titled, ’Lean
Strategies in Health Care Management,’” he says. "However, we needed to give them
a final project, and with this partnership, we could do that while providing
real-life experience in a cancer-related health care setting.”
four semesters, student teams have spent 10 weeks immersed in the use of Lean
to analyze a problem previously identified by Smith and present UC Cancer
Institute leadership with a recommended solution at the end of the semester.
is fact-based, third-party analysis with focus placed on the root cause of the
problems and applications needed to fix them,” says Kamath.
it’s win-win, adds Smith.
finding solutions to real clinical problems at no cost to our health care
system, and these students are getting real-world experience that helps them
gain jobs after graduation; students from this program have a 100 percent
placement rate following completion of the program,” he says.
Bobbili, who completed the course in the 2013 spring semester, says the team
focused on improving the use of electronic health record systems at a rapid
pace to help with timely delivery of chemotherapeutic products to outpatient
clinics with the goal of gaining accreditation by Institute for Safe Medication
health care professionals are too busy or not trained to think about improving
processes,” Bobbili says. "As I progressed through the master’s program in
business administration coupled with a graduate certificate in data analytics,
I was introduced to the Lean Healthcare Six Sigma elective, which thrilled me,
as I was looking to learn to be as productive and effective as I could if applying
Lean to daily project work.
enrolled for the course, and during our first kickoff session, I found out how
Lean application has been addressing operational and administration issues by
using departments and people dedicated to quality improvement. I realized Lean
is unique because although it was a systematic and proven method, it also had
the authority and infrastructure to sustain real change.”
Bobbili, who now is employed as a senior project manager and implementation
lead at Altruista Health, says the course helped in gaining knowledge and
insight in forming a strong argument for a Lean-based health care system and in
understanding the "nitty gritty” of established quality-management tools.
says that all the projects completed during the course have solutions that are being
implemented. One recent project involves the creation of a system to ensure that
patients have the opportunity to preserve their ability to have children after
completion of their cancer therapy and another focuses on the reorganization of
processes to help speed up the start of inpatient chemotherapy.
of the changes are centered on communication and culture change—doing things
differently for a better result,” says Ratee Apana, PhD, associate professor of
business who is also involved in the partnership. "It’s less about what people
are doing wrong and more about changes in processes to enhance the results.
are also mentorship opportunities available for former students. It really follows
a multidisciplinary approach and allows people to think laterally.”
adds that the hope is to carry this partnership into other areas of the College
of Medicine as well as the other health colleges at the Academic Health Center,
including allied health, pharmacy and nursing.
this meeting of resources, students are getting the best training possible and
patients are getting better care,” he says.