Hospitals improve care by borrowing strategies from manufacturing

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Researchers recommend hospitals apply management strategies from manufacturing and technology industries to produce high-quality  outcomes, according to a study in JAMA Internal Medicine.

The researchers collected management data on 597 cardiac units, representing more than half of hospitals with interventional cardiac catheterization laboratories, and found that manufacturing management practices like Toyota's Lean initiatives led to lower 30-day mortality rates and improved process-of-care measures.

"Although a lot of effort has been focused on the use of evidence-based medicine to improve the quality of clinical practice with some important successes, our study results suggest implementing organizational strategies and management practices that enable and incentivize high-quality health care may also be beneficial," study leader K. John McConnell, Ph.D., from the Center for Health Systems Effectiveness Director at Oregon Health & Science University (OHSU), said last week in a statement.

McConnell also noted that hospitals won't have to spend major dollars to implement moderate-scale manufacturing techniques.

But by focusing only on cardiac labs, the study highlights a deficiency in measuring healthcare improvement efforts--a silo mentality that prevents the industry from improving care across the entire continuum, according to an invited commentary in JAMA.  

Nevertheless, some hospitals have found organization-wide success with lean manufacturing techniques. For example, Virginia Mason Medical Center in Seattle adapted the Toyota Production System into its own Virginia Mason Production System and increased employee and patient satisfaction, Virginia Mason Chairman and CEO Gary S. Kaplan wrote last week in Hospital Impact.

Under the manufacturing model, the hospital's nursing teams redesigned workflow so they could focus more on patient care.

"We are achieving the seemingly contradictory outcomes of lower costs and higher quality," Kaplan wrote in the blog post.

For more:
- check out the research announcement
- here's the JAMA abstract and commentary

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