Processes are how work gets done. They are a series of activities that convert an input into an output for the customer or next stage of work. Healthcare is fundamentally a service industry with processes as its product. Because efficiency has never mattered in a fee-for-service world, healthcare is overripe with opportunities to innovate.
Innovation through rigor
Most people think of innovation in terms of products: Apple, Google, etc. We always hear about those game changing product launches that corner a market. While there are still plenty of innovations to be had for new treatment modalities and groundbreaking therapies, healthcare organizations are primed and ready to see major shifts in organizational performance by innovating their processes. What we, at APQC, refer to as innovation through rigor.
Some of the best representations of these principles come from the Toyota Production Systems (TPS), or the Toyota Way. The basic principles of TPS go to the core of what healthcare has purported for years and drive straight to the center of why many healthcare organization were created in the first place. The principles of TPS are:
- Continuous improvement
- Respect for people
- A long-term philosophy
- Belief the right process will produce the right result
- Developing your people and your partners adds value to the organization
- Continuously solving root problems drives organizational learning
When I read through this list, I am amazed at the parallels I see to the mission and purpose of the healthcare organizations I’ve been a part of over the last 20 years. Why, then, is there a disconnect between most healthcare organizations and the concepts of continuous process improvement.
Binary focus
It comes down to a singular, binary focus of many organizations. Healthcare organizations tend to focus all their energy serving the patient. Now, before you lambast me, let me explain.
I’m NOT promoting that the patient shouldn’t be a key focus of any healthcare organization…far from it. It should be the central focus; it is why you the organization was created. I’ve found that some healthcare organizations (and many non-healthcare organizations) take on a hero’s mentality to serve the patient at all costs, which ultimately leads to very convoluted and at times unsuccessful approaches to serving patients. The exact opposite of what they have intended.
Instead of thinking about how to treat THIS patient the right way, the organizations innovating through process are figuring out how the treat ALL patients the right way. Thus creating an organization innovating patient care through the way they work with patients, not just the technology, treatment, or modalities they apply to a single patient.
Falling short
When I look at the principles of process innovation noted above, I think healthcare respects people, does focus on long-term solutions, and focuses on developing people. I think they tend to fall short on their continuous improvement focus, focusing on how they work vs. who they work on, and stepping back to understand and solving their root process problems.
We’re already seeing examples of the use of continuous process improvement and process innovation within healthcare at organizations like Virginia Mason, ThedaCare, and others. They are able to apply these process innovation principles to impact the real outcome for all patients, showing us all that it isn’t an either/or problem. Stronger, more innovative processes will result in better patient outcomes, better financials, better HCAHPS scores, or whatever process outcome you choose to measure. The key is taking a more holistic, process approach vs. a binary vies creating tradeoffs between the care of patients and other outcomes such as financials or patient satisfaction. That is not a place any organization wants to find itself.
