ABSTRACT
As process consultants, too many of the improvements that we have tried to implement in healthcare failed. We came to understand, after a good deal of review, that they were built on the shifting sands of poorly documented processes carried out by well-meaning people in highly variable ways managed by people who did not always see enough of the picture. If errors and inefficiencies in healthcare surprise you, then you likely have not studied the frequently inconsistent, undocumented, wildly varying, and unfortunately, expensive industry we call the healthcare “system.”*
From our vantage point, all healthcare organizations strive to improve the services they offer. They seek cost savings and compliance with regulations and guidelines. Every healthcare organization we have surveyed has commissioned process improvement teams and trained them to follow programs that have revolutionized the manufacturing industry, such as CQI (Continuous Quality Improvement), Plan-Do-Study-Act (PDSA)
cycle, Six Sigma, Lean, and Lean Six. Staff have been trained, scope statements written, and scorecards implemented. Despite these efforts, we were astounded by the number of projects that failed to meet their stated objectives and whose measures of success showed diminishing or no returns. Why would processes used so effectively in manufacturing fare so poorly in healthcare? Why have we not seen breakthrough improvements in costs and quality? The level of service has not increased as costs decreased-why? What keeps the healthcare industry from achieving the same improvements that we have seen documented in manufacturing?
