Last post, I talked about how world-class healthcare organizations focus on process. Before that, I talked about the importance of placing the patient at the center of that process. Today, I’m going to put that all together and talk about the end goal of any world-class healthcare facility: quality care.
 
In healthcare, your reason for being is quality care. To be a world-class healthcare organization, you must excel at deploying rapid, effective patient care.
 
Rapid quality care deployment begins with a sense of urgency.
 
World-class healthcare facilities feel a "survival sense of urgency" throughout the organization, always aware that patients may move on to other care providers offering better care.

​This sense of urgency can be directly generated by outside forces. It is a defensive posture. Or, this sense of urgency can also be generated as an attack on a "crisis" whose impact has not yet been felt. 
 
This is urgency generated by internal forces, ordinarily by the organization’s leadership.  It is an offensive posture. Internal urgency is what I see from leaders who are ready for change. Leaders who are ready to overhaul their systems and commit to delivering the best care to every patient, every time.
 
News services must be quality assured, they must meet customer expectations, they must be state of the art, and they must be available immediately. This sense of urgency intensifies improvement and quality assurance efforts. It intensifies focus upon customer expectations. It intensifies efforts to incorporate new technology. And it pulls together all organization’s human capital to get new services and standards of care ready for the very next patient who walks in the door. 
 
The result is that world-class organizations accomplish amazing development speeds for new care technologies and new methods of care delivery. Patients are satisfied—and impressed. Quality care deployment is rapid and effective.
 
Longer-term benefits are realized. Patient satisfaction increases. Quality improves dramatically. Patient care achieves total quality goals. Patients return again and again because they trust that they are going to get a safe, quality product, fast.
 
Up next on the blog: building a world-class leadership structure.

​In many ways, the healthcare and manufactuing industries seem at odds. Healthcare is about healing people. Manufacturing is about processing materials. But my mission has been to bridge the gap, to prove that delivering the best healthcare relies on the processes you have in place—the processes that create the flow of patients, family, providers, medicines, supplies, equipment, and information.
 
Bottom line: Cut down your time getting everything in place, and you increase face time with patients.
 
World-class healthcare organizations understand this principle. They think of their processes as a strategic weapon—The Big Gun.
 
What does that mean?  The best healthcare. The least waste. The lowest price. The shortest time.  Right the first time. Processes are valued as core competencies.
 
Kanban, a way of automatically signaling when new parts, supplies, or services are needed, is essential to transforming hospital operations. If supplies aren’t in their correct place when they’re needed, you jeopardize patient safety. At the same time, oversupply leads to wasted space and inventory. When I was in the Saskatchewan province in Canada, I watched the Five Hills Health region design their kanban process the right way, working and re-working the system:

​World-class organizations search relentlessly for ways to reduce waste, reduce cycle time, and reduce inventory. They look constantly at their processes. They search ceaselessly for improvements. They work patiently for small refinements. 
 
During the Japan Study Missions, we noticed that there were more "process engineers" in the world-class factories we visited then we'd seen at other companies. These process engineers work on production processes and methods every single day. They know their processes. They take pride in that knowledge. They understand better than anyone else how the production system fits together, how the factory machinery operates in the process, what they want the process to do, and how important it is to find better ways.  Processes are not just studied—they are aggressively scrutinized and regularly improved. 
 
Do you know what one process engineer told us during our visit to his factory in Japan?  He told us that the manufacturing equipment is in the worst shape it will ever be in on the day it is delivered new from the supplier!
 
Healthcare organizations need people with the same kind of process focus, people whose primary responsibility is to improve the processes that can improve the care. Leaders are also essential to continuously improving process. Lean leaders need to be on the front lines, seeking improvements at every level of operation.

​Here’s Maura Davies, former CEO of the Saskatoon region in Saskatchewan, Canada, implementing kanban at Home Health under the expertise of Sensei Narita. She’s a great example of what it takes to achieve the promises of the Toyota Production System. She’s not in her office. She’s on the front line, getting involved in improving the process, piece by piece.

​World-class healthcare organizations have an intense patient focus.
 
Talk is not enough.  "Patient focus" is more than just a pleasant slogan.
 
World-class healthcare organizations are redefining the idea of patient focus.  They know that true patient focus is not passive—it is active, aggressive, passionate, fervent, energetic, and tireless. You must have an unconditional commitment to your patients.
 
The patient is not just involved in the process—the patient is an indispensable part of the process, and it doesn’t work without the patient's involvement. Care cannot be delivered or innovated in a vacuum.
 
This means inviting patients into their care.  This means pursuing what the patient wants—chasing down what they need both in terms of medical care and in terms of the atmosphere, logistical processes, and family support that may be involved—until you get it right. It also means leaving behind attitudes such as, “That’s the way we have to do it,” and “Look, this is how we do it around here,” or worse yet, “Patients may not like it, but it works better for the doctors or staff this way.”

​World-class organizations have realized that success happens when they center operations on patient needs. What do I mean? I mean you no longer have to make educated guesses about patient expectations. You just ask the patient. Then you shut up and listen.
 
The best intentions in the world mean nothing if your patient isn't satisfied with and impressed with his care.  Patient satisfaction is the key measure of performance.
This focus on patient satisfaction does not compromise medical care or organizational efficiency. It enhances both.
 
Patients are at your doorstep because they need your help. They are hurting. They are going through medical crises they can’t solve on their own. But at the end of the day, you have to believe that the patient ultimately knows what is best for them. The patient — and sometimes, their loved ones — can and should collaborate with you on their care.
 
How are the best organizations focusing on their patients? First, they include the patient in the process of collecting information about his needs and expectations. Next, healthcare professionals analyze what that information means and learn to understand it in the context of the medical situation and care environment. Then, they implement the results by creating the care plan that best meets patient expectations, needs, and preferences. Finally, they measure patient satisfaction, including the medical, emotional, and logistical aspects of their care. From start to finish, the approach is true patient focus.
 
When world-class Lean leaders focus on their patients, they achieve real results. They put patient input into action. Take a look at the experience of Ted Gachowski, a patient at Virginia Mason when JBA was consulting there.

​I highlighted Ted’s case and the leadership of his doctor in the second edition of my book:

​Ted’s physician, Dr. Henry Otero, saw the needless difficulties created by the treatments that were supposed to be helping Ted feel better. Otero galvanized the hospital staff to find solutions, and greatly improved the quality of Ted’s care.

​Patient focus, front and center, put into action by Dr. Henry Otero, a world class leader who gets it.