Priming for Patients: Walking before running with lean

Nathan Liewicki
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Dr. Fred Wigmore is the Five Hills Health Region's senior medical officer. On Wednesday, he discussed the importance 'lean' principles will have on the health region, including the need to walk before running with lean.

Physicians speak positively about lean principles

As Moose Jaw readies for the opening of a new hospital, the facility and the term ‘lean’ has been frequently discussed. The voice of doctors toward all of it has, however, not been a prominent part of that discussion.

On Wednesday, the Times-Herald sat down with a pair of doctors to discuss their take on lean principles and the important role they will have in improving patient experiences in the healthcare system.

Recently retired from 30 years of practice as a family physician, Dr. Fred Wigmore serves as senior medical officer for the Five Hills Health Region (FHHR).

Although Wigmore admitted his new role was not something he planned on doing, “the role interested me.”

Fond of lean practices, Wigmore was involved in one of the recent Rapid Process Improvement Weeks (RPIWs) the FHHR held at the Moose Jaw Union Hospital, which are designed to make improvements to various areas of healthcare.

“What you take away after being involved in an RPIW is that you appreciate the amount of hard work that goes into trying to make things better,” said Wigmore. “The changes they make to improve the efficiencies and disciplines to run a hospital are measurable, reproducible, and accountable.

“That – as a management tool – is excellent in healthcare.”

Wigmore spoke to the concerns some people have regarding the biggest fear of lean in the healthcare system – downsizing – by stating that lean is not a rationing program.

“Lean is designed around standardizing job descriptions with efficiencies, discipline and accountability, and that's what makes it special,” he said.

Wigmore added that doctors themselves have an advantage from their training that will aid them in combating any challenges that may arise in association with lean practices.

Medicine changes rapidly, so physicians are used to change, he noted.

“Once they see the efficiency and the accountability of the change, they usually accept it wholeheartedly.”

He also pointed out that the physicians who became most involved with lean practices are the ones who have embraced and understand it the best.

One of the mantras of lean is the right person, in the right place, at the right time.

“It's a cornerstone of lean discipline and efficiency,” said Wigmore. “It's what we work towards.”

Saskatchewan is working toward the adoption of a province-wide standard; one Wigmore noted has never been seen in the Land of Living Skies.

“It's not one region operating in a vacuum,” said Wigmore. “It's a province using the same management technique with similar goals in mind that allows communication between Moose Jaw and tertiary hospitals at a clearer level because we are all learning from each other to have similar metrics.

“That's a huge advantage.”

Another important advantage of a province-wide lean initiative is it creates an environment that is patient-first, staff friendly and one pleasing to taxpayers.

Wigmore believes the further adoption of lean principles in the healthcare system will be nothing but beneficial.

“I think it will create a monetary environment that might let us move forward in acquiring equipment, services and people that the region of Moose Jaw has always wanted,” he said. “I think lean might give us the tool to do that, and I'm enthusiastic about it.”

However, something taxpayers are not enthusiastic about is wasteful spending.

It’s estimated that 30-40 per cent of all money spent on healthcare in Canada and the United States is wasted. With lean, the Canadian medical industry could potentially save in the neighbourhood of $8 billion annually.

“If you can save that amount of money, think of how you can use that to start addressing the social determinants of health,” said Dr. Mark Brown, who runs his own medical practice in the Friendly City.

Brown acknowledged that getting everyone on board with lean will not be easy, but there are elements of it he likes. Most notable among those is the eradication of waste.

Brown told the Times-Herald there are “slicker ways” the healthcare system can clean up its act. Lean practices are among them.

“You've got to ultimately get everybody, especially down at the grassroots level, thinking the same way, starting to analyze what they do and figuring out how they can do their job in a more efficient way,” he said.

FHHR physicians like Brown have already and will continue to face challenges pertaining to lean. Like Wigmore, he noted the more involved physicians are in leaner initiatives, the better the system will be for all parties involved, especially patients.

“You have to remember that lean isn't rocket science in the sense that you don't need somebody to come and say, 'we are going to do a lean initiative.' Anybody can do it at any time,” said Brown.

One of the problems with the current healthcare system, Brown said, is found in its bureaucratic nature. Certain problems have been identified, but in some instances it has taken years before any beneficial changes occurred.

Lean, Brown argues, has the ability to significantly shrink the time between identifying a change is needed and when that change actually takes place.

However, he was quick to point out that healthcare workers need to have the courage to say an idea didn’t work, throw it out and try again.

Lean initiatives are becoming more widespread, but taking gradual steps toward achieving the biggest of goals takes time.

As Wigmore said, “with lean you have to learn how to walk before you can run.”

Nathan Liewicki can be reached at 306-691-1256 or follow him on Twitter @liewicks

Organizations: Times-Herald, Moose Jaw Union Hospital, Land of Living Skies

Geographic location: Moose Jaw, Saskatchewan, Canada United States Friendly

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Recent comments

  • Lean
    February 26, 2014 - 18:52

    Now please do an article with a Dr. or Specialist who may be against this and show us all the other side of the story.

  • Barbara Latham
    February 23, 2014 - 16:35

    Wigmore's enthusiasm for good health care is about to capture a wider audience than in his GP days; that's a good thing.