Campus lean management research center to investigate streamlining hospital care

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The UC Berkeley School of Public Health announced Thursday the opening of its Center for Lean Engagement and Research in Healthcare, or CLEAR, to research lean management’s potential to streamline care in hospitals.

Lean is a style of management used in several fields that emphasizes collaboration between employees to improve efficiency. It has been adopted by more and more hospitals, but few rigorous studies on its effectiveness exist, according to Thomas Rundall, a professor emeritus in the campus School of Public Health.

“Our co-sponsors … believe that the lean approach to management holds promise for reducing cost and improving quality (of healthcare),” Rundall said. “Most observers of hospitals believe there is a great deal of waste in the way care is organized and delivered to patients.”

Lean management was created during the 1950s by Toyota to streamline its car manufacturing process. It has since spread to other areas such as retail and financial services, according to Chet Marchwinski, spokesperson for CLEAR’s co-sponsor Lean Enterprise Institute.

In hospitals, lean has been applied to emergency rooms and cardiac care units to eliminate unnecessary steps in administrative and medical processes, Rundall said.

“(Existing research) shows some instances where lean has been found to be successful, and instances where lean has not produced its intended results,” Rundall said. “That is part of the work of CLEAR: to enable us to better understand why we see this variation.”

So far, CLEAR — co-directed by Rundall and campus professor of organizational behavior Stephen Shortell — has created an annotated bibliography of existing research on lean practices in hospitals. The team will conduct a survey of hospitals across the United States next year and is considering selecting a group of hospitals to study for five to seven years, Rundall said.

Marchwinski said in a certain intensive care unit, patients were spending too long in the ICU after heart surgery. Hospital staff worked together using lean management strategies, he added, and identified that breathing tubes weren’t being removed promptly because doctors had different ideas of when the tubes should be taken out after surgery.

Doctors and nurses used the lean model to create a standardized process, Marchwinski said, and afterward were able to move patients to the recovery room sooner.

Campus junior Justine Po, who works on the project, said the research will have “a very strong impact” on public health.

“If we find lean is effective, that’s a good sign, that’s something that should be implemented in more hospitals,” Po said. “If there’s significant evidence that disproves (lean’s effectiveness), that would be a sign that investing resources in this program would not be the best option.”

The project is co-sponsored by the nonprofit Lean Enterprise Institute, ThedaCare Center for Healthcare Value and Rona Consulting Group.

Contact Lillian Holmes at [email protected] and follow her on Twitter at @LillianQHolmes.