Change in health care: the centrality of the person

When we talk about public health care in Italy immediately the thought goes to the problem of its efficiency. Scenarios are changing quite rapidly and see on the one hand ever-increasing expectations in terms of quantity, quality, results and customer care, and on the other an increase in complexity and technical-scientific innovations, which sometimes struggle to be sustained by “mature,” sometimes even obsolete, organizations. If we take into account the fact that the average age of the population is steadily increasing, and the number of patients needing health care and interventions is proportionally increasing, then the realization emerges that we are in the midst of a real vicious cycle. In this context, many examples of “slimming cures” are beginning to break through, with fierce health care administrators being engaged in real cost fights, trying to cut as much as possible. But cutting costs is almost always a long way from cutting waste, in health care as in any other organization.

Sustainable change in health care through Lean Thinking

Lean Thinking, a Toyota-originated methodology whose main goal is to cut down all waste in the company by having the end customer and people at the center of its attention, can be a key turning point in this sector, as is already happening with brilliant results in health care facilities in other countries, such as Britain, Sweden, and the United States. As long as we have a particular “eye” to our particular context and the people in it.

“Go to the people…Live with them. Learn from them. Start with what they know. Build with what they have. But with the best leaders, when the work is done, the task brought to a conclusion, people will say, ‘We did this on our own.’

The wisdom of these words, written by the Chinese philosopher Lao-Tsu (604 – 531 B.C.) remind us, more than 2,500 years later, how the difference between success and failure in a change project lies entirely in the ability to trigger people’s emotional “engine” toward a common goal.

“Technical” excellence is never unrelated to “social” excellence and the well-being of the people who are the protagonists of change, and this, in the case of the health care sector, can only be achieved if the old bureaucratic-functional organizational models are abandoned in favor of horizontal integration, broadening the vision of corporate objectives to include all the key players in the so-called “value stream” and moving from an organization by sectors/departments to an organization by streams and lines of activity. As I explain in my book “Lean Innovation. Strategies for Enhancing People, Products, and Processes,” without the willingness and ability to create a system in the company that ensures people’s capacity for continuous, autonomous improvement, it is not possible to achieve significant service improvement goals, performance time reduction, and widespread waste reduction.

Today, more than ever before, health care companies suffer perhaps more than other industrial settings from waste that undermines both the level of service and financial performance and, not least, the well-being of the people within the company. Constant variations, changes, errors, delays, waste, excessive costs, waste of various kinds, and wrong habits are just some of the terms in a now-recurring vocabulary that can burden processes and activities.

No innovation or technology can replace man in his creative ability to analyze reality in the discovery of continuous sources of improvement and renewal on various fronts. This “fact” brings man to occupy a position of absolute centrality in any health care enterprise, even technologically advanced ones. All tools and techniques for improving productivity or introducing elements of innovation are useless if not linked to changing, for the better, the emotional state of people in the company. At best, they can lead to timely and short-term improvement in only a few specific areas of the company. In other words, when there is a lack of a strong link between productivity and well-being, it is not possible to sustain innovation and continuous improvement in the company over time, which in fact represent the two elements that can make the difference between mediocrity and excellence in a business today.

These considerations lead me to say that as long as our companies are made up of people, it is people who will ensure the success or otherwise of any initiative. Getting people on board the initiative, not only sharing with them the business motivations, but also listening to their individual motivations, converging toward a common state of “urgency of change.” Aiming at people’s well-being, in conjunction with the need for increased productivity and innovation in the company, not only helps, but becomes absolutely synergistic and the only guarantee of the sustainability of structural change in the long run.

Changing health care looks far ahead

Doing business today, especially in the health care sector, means having regained a long-term view and defining processes in the short term that can activate improvement at all levels of the company, not to make paper to accumulate in dusty folders containing often forgotten and unused procedures, but to create new habits that can concretely empower individuals and groups. The projects I have had the honor of personally leading to success have taught me that every time it is almost normal to feel “scared” when faced with initiatives that at first glance seem like real mountains to climb. I also learned that if we want to succeed and achieve prosperity, we can never stop, but we must always try to figure out what the first step can be for us and do it the best we can. Because, only after doing so, we can be able to get a good look at the second step to be taken. We will find ourselves after months, perhaps years, having reached heights we would have thought impossible to climb.