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Lean Hospital –
a cure-all?

hpo Insights

Lean hospital – a cure-all?

hpo Insights

The Swiss healthcare system is facing major challenges. “Lean hospital” was long considered a cure-all, but it did not bring the desired success in many cases.  The reason is simple: While “lean hospital” optimizes detailed processes, it does not address the fundamental design flaws for a patient-centered healthcare system. Here is where a process model derived from the strategy comes in handy. Learn more with these hpo Insights.

Creating prerequisites

Increasing quality at decreasing costs

Everyone agrees on one thing: the Swiss healthcare system is facing major challenges. Rising costs, lack of specialists, or the increasing demands of patients are just some of the issues that cause sleepless nights for many hospital directors.


“Lean hospital” tries to meet these challenges. Using numerous methods and tools, it aims to optimize the process flow by avoiding waste, such as unnecessarily high administrative effort or long waiting times.


Expenses should decrease, quality and thus patient and employee satisfaction should increase. This sounds comprehensible and consistently attractive. But as so often, appearances are deceptive.


Not losing sight of the big picture

In recent years, more and more Swiss hospitals have jumped on the “lean hospital” bandwagon. However, relevant experience reports are not only positive. Indeed, “lean hospital” has already put a spoke in the wheel for some hospitals.


Why? The answer is simple: The big levers for improvement lie in the right combination of the many activities necessary for the well-being of the patient. If this prerequisite is met, the advantages of “lean hospital” come into play.


The effective design of services in the health care system therefore requires:


  • an intelligible and future-oriented strategy;
  • a process-oriented organisation with clear tasks, competencies, and responsibilities;
  • and – not to be underestimated – a culture in line with the strategy.


The big levers for improvement lie in the right combination of the many activities necessary for the well-being of the patient.

Efficiency is only half the battle

If measures fail to work

Imagine that a certain process keeps worrying you. So, take a pen and paper and draw a flow chart of the process. In doing so, you uncover weaknesses in discussion with your colleagues, develop and test possibilities for optimization and take appropriate measures. They are implemented – but somehow, there is no noticeable effect.


However, when it comes to examining individual micro-processes, the problem is that the devil is sometimes not in the details but in the superstructure that goes with them (see example). If this superstructure has significant weaknesses, then fine-tuning the micro-level will accomplish next to nothing.


hpo example: warehouse optimization

An industrial company wanted to optimize a warehouse to be able to supply customers faster and more reliably with better processes.


Based on the hpo methodology Macro Design Delivery 5Md©, we analyzed the company’s service offering with a more holistic perspective. This led us to an astonishing conclusion: By redesigning the value chain, the warehouse was no longer needed!


Instead of optimizing the warehouse processes with “lean,” we simply “eliminated” the warehouse. If we had only focused on the processes within the warehouse, the customer would have an optimized but superfluous warehouse today.


When it comes to examining individual micro-processes, the problem is that the devil is sometimes not in the details but in the superstructure that goes with them.

Business process model as a basis

We understand the “superstructure” of the micro-level to be the business process model. This is derived from the services defined in the strategy, i.e., from marketing, procurement and production (or provision of a service) to delivery and invoicing, and represents the entire value creation of a company.


Just like “lean hospital,” the hpo methodology Macro Design Delivery 5Md© has its origin in the industry. We have established and proven in numerous projects that the systematic derivation of the business process model also creates great added value for companies in other industries.


Benefits for your health care institute

The immediate application that emerges from the business process model of a hospital, psychiatry, or other health institution is the derivation of the process-based organisation. Based on the model, we identify which competencies are required for which work step and how the individual processes interact.


A process-based organisation meets two essential criteria of a high-performance organisation: patient orientation and continuous responsibility. The process model at the macro level is also the foundation for the management of hospitals with several locations and the development of promising cooperation models.

Key issues are:


  • What services do we want to provide, and where?
  • How do we ensure that the continuity of treatment for the patient is guaranteed?
  • Which know-how is required at which locations?
  • How can it be made accessible for the treatment of all patients?


Last but not least, the development of the business process model and the associated organisation also promotes the willingness of the workforce to change. During the development process, we always involve key persons from different hierarchical levels and areas on the customer side. If they can help shape their own future, they will be eager to convince the others of the new solution – and to implement it.


“Lean hospital” – a cure-all?

Despite its proven qualities, “lean” is not a cure-all.  A clear business process model and the organisation derived therefrom are the basis for a patient-centered and effective organisation. Only on this foundation can “lean hospital” and comparable methods contribute to the further deepening of the efficiency concept.


A process-based organisation meets two essential criteria of a high-performance organisation: patient orientation and continuous responsibility.

Successful symbiosis

Voices of satisfied hpo customers

“We knew that we had the potential for optimization. But we were unable to locate it. Thanks to the integral hpo methodology, we were forced to question fundamental principles. It very quickly became clear to us where we wanted to go.


The clear presentation of the solution approaches then enabled us to make a quick decision. Today we have a structure in which the medical departments work according to the same guidelines and efficient mechanics. The solution competence of a combined customer-consultant team, is a guarantee for successful implementation.”

Prof. Dr. Sönke Johannes
Medical Director and Medical Head of Neurological Rehabilitation,
Rehabilitation Clinic Bellikon
Prof. Dr. Sönke Johannes
“Over the past decades, Psychiatrie Baselland has historically developed a parallel structure with an inpatient clinic and an organisation with outpatient clinics and day clinics spread throughout the canton. It became increasingly clear that this current separation of out patient and inpatient service provision had several weaknesses with regard to the future. Together with a team of outpatient and inpatient managers from the medical and nursing sector, hpo prepared a well-founded analysis of the current situation – supported by all parties involved – making strengths and weaknesses transparent. A future-oriented organisation for adult psychiatry was designed based on strategic considerations for the medium to the long-term orientation of PBL.”
Hans-Peter Ulmann
CEO,
Baselland Psychiatry
Hans-Peter Ulmann

Your strategy consultancy for enterprise design

Who is hpo?


hpo makes companies more successful and more innovative. The strategy consultancy for enterprise design boasts more than 20 years of experience in the creation of strategies and organisations spanning many different industries. The management consultants at hpo specialise in the meticulous development of strategies, processes, business models, innovation and culture, and in the consistent alignment of these together with their targeted implementation.


The hpo design approach enables companies to better cope with strategic and organisational challenges and to realise substantial competitive advantages. The basis of the industry-spanning design approach is an academically grounded methodology with which companies are shaped and which is continually further developed with the latest findings from research and practice.


The management consultants at hpo come from a commercial or technology background and stand out with their high level of analytical and emotional intelligence. They are passionate in their dedication to the client’s concerns and enjoy working in a team.


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