The cost of Obama’s Health Care plan as presented to the public is unsustainable. The American public wants affordable health care not what is being forced upon them. No real attempt has been made or if there ware it was a dismal failure to eliminate the massive waste in the current system. Congress has not acted to prevent the waste and corruption found in our health care system. Americans simply can not afford or be expected to pay for a health care system that is the most wasteful and expensive in the world. While all the current health care waste has been passed to the public little has been done to make the health care operations themselves efficient and effective.
It does not have to be this way we do not have to choose between raising taxes or cutting entitlements we can pursue a third alternative, making government more efficient and effective.
The solution
The approach presented here is unique to government it borrows efficiency and effectiveness tools used in private industry: to fix the entire healthcare delivery system from government bureaucracies all the way down to the detailed emergency and operating rooms practices. The health care industry is just beginning to implement the Lean tools found in industry yet Congress has demonstrated a complete lack of understanding of how these tools can be used for reforming government and for fixing the Nation’s health care systems.
The Author’s Health Care Recommendations
Organizing for Implementation of Recommendations:
National Level:
Establish a National Healthcare Think Tank
The think tank is divided into two parts: Health Management systems and Medical procedure systems. The think tank will use Lean to evaluate alternatives related to management systems and Medical procedure systems. The result will be the selection of the best approach for Management systems and Medical procedure systems.
Establish a National health Care Reform Commission
I recommend that the Federal Government establish a “National Health Care Reform Commission” to oversee the implementation of my recommendations.
State Level:
Organized by the State to fit state needs in management of state Healthcare.
Local hospital level:
The every hospital in the Nation will implement my General Reform Model using Toyota’s Enterprise Lean to create a culture of innovation and continuous improvement in health care worker’s jobs. See the following Sequence of implementation of recommendations.
Recommendation One: Stop Health Care Waste
Congress should implement laws curtailing all waste from fraud with stiff punishment by firings and jail time. Most fraud and waste goes unpunished today because perpetrators are protected as agency employees by their agencies.
A major thrust should be made to eliminate waste from agency duplicated responsibility and activities by using the author’s Consolidation Reform Model based on Enterprise Lean.
Recommendation Two: Apply Lean Six Sigma to Health Care Systems
Health Care Think Tank Level
The goal is to make high level government health care delivery systems more efficient and effective by implementing Lean Six Sigma on a massive scale for all high level Federal health care systems. This approach is to bring in Lean Consultants to use Lean Six Sigma to fix the high level healthcare systems.
Recommendation Three: Reinvent the National Health Care System
Local Hospital Level:
The Federal government can save National healthcare by implementing my General Reform Model with Enterprise Lean throughout the American healthcare System including all of the Federal government’s health care agencies and all of the nation’s hospitals.
Enterprise Lean Trains all health employees to use the lean tools to make each of their jobs efficient and effective. This is a cultural shift that empowers health employees to innovate and make continuous improvement to their jobs on a daily basis. Enterprise Lean is the first phase of the author’s General Reform Model. The General Reform Model should be implemented after most waste and duplicated activities have been eliminated to avoid making the production of waste more efficient.
There are two main Lean tools that Lean Teams will be implementing in health care as required by the General Reform Model: Value Stream Mapping (VSM) and poka-yoke. The Japanese term Poka-yoke is translated “to make activities error proof”. Hospitals use poka-yoke to implement specially designed systems to prevent human errors from occurring when administering drugs to patients.
The Value Stream Mapping tool is used by Lean Teams to study the flow of processes in their work functions assessing the value of each process to their customers (the users of the systems). Processes that have no value to the customer are eliminated where possible. Each function is revised to get the highest efficiency and effectiveness.
The Steps of the General Reform Model
1. Formation of a National Health Care Reform Commission to oversee the implementation of the government reforms.
2. Implement Enterprise Lean Teams in all government health care agencies to empower personnel to innovate and make continuous improvement to their jobs this fixes all government systems getting the highest efficiency and effectiveness possible. And implement Enterprise Lean in all of the Nation’s hospitals to get the highest efficiency and effectiveness possible.
3. Documentation of the Lean Team’s improved methods and the time to do each function is done by Budget Analysts with special training by the consultant. The data is used in the next step for right-sizing the organization. This corrects the problem of not knowing where to make cuts by making all government functional costs transparent to Budgeting personnel.
4. The employee work force is Right-Sized to fit the workload (making sure each employee has a full time job). this step uses the Lean Team Data as Work Measurement to Right-size the organization. It is important that redundant employees must be removed from the work environment and retrained for new jobs or laid off.
5. Improving Efficiency in Office Workload Planning and Scheduling by first grouping functions by skill level and expertise. This is followed by developing a weekly Work Load Plan. As actual data is developed the plan is revised for continuous improvement.
6. The bureaucratic organization is replaced with a Team Managed organization.
No comments:
Post a Comment