Efficiency and the Workforce

The Aug. 9 column in H&HN Daily, "Cut Costs by Reducing Redundant or Inefficient Activity" by Mark Graban and Rob Harding, generated a lot of reader response. Here's an edited sample:

Respect for people is an extremely hard concept to grasp and, unfortunately, comes into the Lean conversation well after the engagement has started. Most organizations want results and see tools, not respect, as the path to results. … When respect for people is not continually managed and kept at the forefront, damage control down the road is almost impossible to reverse, i.e., how do you convince hospitalists who were timed going to the bathroom that they should value and engage in the Lean effort after all their personal privacy was significantly invaded by "Lean"? Failure to manage the "respect for people" conversation leads to resentment and disengagement in the one area that health care likely has the greatest to gain — eliminating waste.

M. Heinrichs

I fully agree with your sensitivity to layoffs or staff reductions, but do not see how you reconcile this: 60 percent of a hospital's costs are tied up in labor. How can you reduce health costs by 50 percent without impacting labor? If the answer is to "reassign" the staff to some other task, then how critical is that task considering it was not being done; and if the transfer requires retraining, what about the costs of retraining? Given the very high labor costs of health care, I think the promise may be a little disingenuous.

Frank Poggio
The Kelzon Group

If Lean principles are implemented, efficiency and throughput can be increased significantly. For example: Patient scheduled for surgery after one month now can be operated on in seven days or in emergency rooms; instead of waiting for three hours, now patient gets treatment in 30 minutes. This will result in more patients served with same amount of staffing (the base cost). Not only [does] this increase patient satisfaction, but high throughput will increase revenue. You don't always want to cut staff; [you can] get more done without increasing staff, and Lean can help.

Sanjay Patel
Cardinal Health