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Download The Lean Prescription: Powerful Medicine for Our Ailing by Patricia A Gabow; Philip L Goodman PDF

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By Patricia A Gabow; Philip L Goodman

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Extra resources for The Lean Prescription: Powerful Medicine for Our Ailing Healthcare System

Example text

Fourth answer: They are still on attending rounds. Fifth why: Why didn’t they write the orders before attending rounds? Fifth answer: No one has told them to do that. Now you can begin to explore a solution to that problem.

We ask why five times” (Liker, 2004). An experienced Lean Tool Box • 41 Lean sensei has said that “90 percent of all quality problems can be solved just by … asking why five times” (Koenigsaecker, 2013). Pretty impressive for something so simple. The 5 whys can be used in a variety of ways and on several levels. The 5 whys “peel the onion” on a process or a problem. ” Each of these deserves not just the first “why,” but four more in order to reach the core reason for the approach. Often, it becomes clear that there is no good reason it is done that way.

The mere fact that we have waiting rooms everywhere in healthcare demonstrates a key problem with flow and an overall acceptance of this waste. Patients being “boarded” in an emergency department waiting for a bed. Patients staying in the hospital waiting for a procedure not available on weekends. Patients waiting for discharge until doctors finish rounds and write orders. Physicians waiting for patients. There are many examples of this including surgeons waiting for patients in the operating room because some preoperative process failed or simply that the room turnover was delayed by roadblocks in that process.

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