Lean & Mean Health Care
Publisher: Against the Current
Date Written: 01/05/2014
Year Published: 2014
Resource Type: Article
Cx Number: CX20409
Chern examines the Affordable Care Act from the perspective of being an industry and how this will regulate, standardize, and consolidate the healthcare system.
Initiatives like this, often called "coordinated care," aim to redefine the flow of patients through the healthcare delivery system in much the same way that lean, just-in-time production has redefined the flow of commodities through the global supply chain. In Charlie Post and Jane Slaughter's words, manufacturers speed up work and cut down inventories by making sure "each phase of the production process is tightly synchronized with the next."
Healthcare CEOs are exhorting each other to apply manufacturers' lean methods to streamline use of medical equipment and supplies. The lean lessons of the Toyota Production System have been carefully studied by health informatics researchers and the National Institutes of Health, and applied in hospitals around the country.
Like lean production, coordinated care moves the patient through the health care system with much higher efficiencies. Patients may notice this more efficient care, but what appears as coordination or integration from the perspective of capital looks more like a disintegration from the perspective of patients and workers.
Industrial healthcare delivery requires a series of workers who can provide direct care for the patient or regulate the flow of patients through the clinic or hospital. PCMH will multiply this division of labor, creating new steps in the patient flow.