"If the worker hasn't learned, the instructor hasn't taught." From the Job Breakdown Sheet, a LEAN tool.
If an instruction has been carefully explained, and not implemented, it is the fault of the soldier. If the instruction was explained but not understood, it is the fault of the General. The Art of War.
If the company (Hospital) is the General, and they are NOT relaying the tools, time for appropriate training, or human resources necessary to achieve the LEAN goals, then who is at fault? They are assuming, no, not assuming, they are believing with religious conviction that LEAN processes work. The brainwashing works to such a degree that they will point blame at the worker when the LEAN implementation doesn't WORK. Not seeing their own responsiblity in trying to pick an apple from an orange tree.
If an effective trainer in a complicated health care environment can train one person at a time, knowing the training has been throughly learned, can they train 30 or 50 at a time? This is what LEAN would ask in our Hospital. Let's train 50, and have them all turn out not competent to do the job of protecting the patient's integrity.
Would you move a scrub nurse out of the OR to a general floor to make things more LEAN or efficient? Or would you respect her expertise and honor her knowledge of the hundreds of instruments and procedures she knows to be effective in the OR? In the LEAN model, you want no specialization. You want everyone to be able to do every job because it makes things more flexible and "efficient." Does that make one bit of sense?
Would you move a scrub nurse out of the OR to a general floor to make things more LEAN or efficient? Or would you respect her expertise and honor her knowledge of the hundreds of instruments and procedures she knows to be effective in the OR? In the LEAN model, you want no specialization. You want everyone to be able to do every job because it makes things more flexible and "efficient." Does that make one bit of sense?
When the General (LEANster) is commanding more for less without any responsibility for protecting patient care outcomes, it is unacceptable to blame the underling for the training failure. The General has failed.
Healthcare has always been a numbers game, but now it has gone a more cult-ish route. What next, pyramid schemes? Any Kool-Aid anyone?
Can a Hospital's LEAN implementation adversely effect patient care?
The answer is yes.
Could this be corrected?
Yes.
Why isn't it being corrected?
Because the millions spent for the LEAN implementation preclude the administrators from seeing the actual result and the negative patient care impact. Million dollar question, million dollar answer. It's that simple.
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