Key to any lean effort is removing waste, or more accurately, removing wasteful activities. As we identify what’s wasteful, we can focus more on what adds value. Sometimes a “waste walk” will introduce people to waste, as they walk through an area looking for various forms of waste. Even more illustrative is a "process walk," when those that work and manage a process actually walk the entire length of it -- noting wastes, counting steps, timing activities, and deciding what adds value and what doesn’t. Of course, process mapping and value-stream mapping can document waste and value visually, helping organizational members see where work stalls, costs mount, and customers wait or suppliers search as a complicated process stretches out longer than it should.
Following Aaron Preston’s post this week wishing there was more A3 thinking on healthcare policy, I thought we could apply the analysis of value-added and non-value-added activity to the healthcare process. And we could do it from the point of view of healthcare’s customer -- the patient. If we walk, or map, the flow of a patient during a visit for a routine physical exam, we know that that not every activity adds value. Clearly the visit with one’s doctor is the anticipated value of a physical -- that and any useful tests that analyze one’s physical health.
Earlier this year I had a follow-up to a physical exam with my physician, but it really occurred in four stages. First, I visited an independent laboratory to have blood drawn for lab tests, especially a cholesterol test. Second, I visited my doctor to discuss my general health and the results from the labs. Third, I obtained a CT scan that she scheduled for me to follow up on an earlier one. Fourth and finally, my doctor called me after the CT scan to explain the findings. [What happened? My cholesterol is low, the CT scan found nothing, and I am taking more vitamin D.]