Lean in Healthcare: A Personal and Professional
JourneyElizabeth J. Warner, MD FACP CPE
Warner Well Being, L.L.C.
Internal Medicine Physician, Leader, Coach and Human Being
Objectives
Share my personal story about becoming a lean thinker, while serving as a healthcare leader and embattled clinician.
Reflect upon one’s personal journey in parallel to an organization’s lean transformation.
Emphasize some of the unique cultural conditions in healthcare, which influence its lean improvement journey.
Medical Training & Career Path Life Track
1994-1998 Medical School Single, then Partnered
Aug 1998 Birth of first son
1998-2001 Internal Medicine Residency Crisis of competing professional and personal demands
2001-2013 Internal Medicine New Primary Care Practice
Fertility workup & care
June 2004 Adoption of second son
2005 Reduced to part time clinical status
2007 First major episode of burnout First major episode of burnout
2010 Divorce
2012 Primary Care Medical Director Created
Burnout
Cynicism
Exhaustion
Lack of Efficacy
Pivotal Question which re-routed my career
“Why don’t problems stay fixed
around here?”
A Leadership Path opens before me
Survey Results for Primary Care Providers (2012)
• 63% response rate, from one email request
• Over 10 pages of free text responses
• Strong themes of:• Frustration with EHR
• Burden of paperwork and non patient care activities
• NO ONE is listening in leadership
• Helplessness, hopelessness and cynicism
• Exhaustion
Experimentation (“Willy Nilly” style)
Student of lean thinking
TrainingThedaCare Center for Healthcare Value (Now Catalysis), Gemba VisitsUniversity of Michigan Lean for Healthcare certification (2014)Managing to Learn, John Shook, LEI, Toyota Way,
Practicing the toolsA3s and eraser stubble EVERYWHEREAsking “Why?” during meetingsSIPOC and flow mapping in committee work
Flowing any and all resources to Primary Care clinical teams
Quickly, I could see the broken processes and system gaps.....
Leadership Opportunity
For the next three and a half years…
Shingo Principles
Shingo Principles for Operational Excellence
Align
• Constancy of purpose
• Provide value to the customer
• Think systemically
Enable
• Lead with humility
• Respect every individual
• Learn continuously
Improve• Focus on process• Provide quality at the source• Flow and pull value• Understand & manage variation• Embrace scientific thinking• Seek perfection
Lifelong Learning guides me to an off ramp!
And the Journey Continues...
Thank you for your time and attention!
What questions do you have?
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