Can the United States transform its ailing and expensive healthcare system using lean organizational principles? Lean management, first developed and implemented by Toyota in the late 1980s, creates a culture and overall system that maximizes customer value while minimizing waste. In the past decade, lean management has moved beyond manufacturing and into many other industries and services, including health care and government.
A new UC Berkeley School of Public Health center—the Center for Lean Engagement and Research (CLEAR)—will work with organizations on the process of implementing lean principles while studying the effectiveness of the transformations on the patient experience of care, the growth in the cost of care, and population health as a whole. CLEAR is an affiliate center to the Center for Healthcare Organizational and Innovation Research (CHOIR), which has the synergistic mission of studying the organization and delivery of health services in order to improve the effectiveness of care.
“Achieving the ‘triple aim’ of better quality and patient experience, improved population health, and reduced growth in cost will require more than tinkering with parts of the health care system or making incremental changes,” says Professor Stephen Shortell, co-director of CHOIR and CLEAR. “Given payment and delivery system reforms, there is growing interest in whether lean management can eliminate waste and improve quality and outcomes in health care.”
For research purposes, CLEAR defines ‘lean’ as “the development of a culture that enables an overall management system to create value for customers by eliminating waste and solves problems through the daily application of the scientific method in creating standard work.”
CLEAR will operate with partners in both the private sector and academia in the fields of public health and business. The center has both a strategic advisory council, with industry partners such as ThedaCare Center for Healthcare Value, the Lean Enterprise Institute, Rona and Associates, as well as a research advisory council comprised of academic colleagues.
"Collaborating with health care managers and clinicians, as well as researchers from other leading institutions, will allow us to conduct research that will enhance our understanding of lean management and its effects across different types of health care organizations," says Professor Emeritus Thomas Rundall, who will co-direct CLEAR with Shortell.
In addition to core support from the private sector sponsors, individual organizations will support research on specific lean projects of interest, provide data for study and use CLEAR’s research findings to improve the quality and cost of the care they provide. Says Shortell, “CLEAR is in a unique position to develop an evidence base and actionable knowledge to help fulfill lean's potential for transforming U.S. healthcare delivery.”