White paper compares Lean and IHI
They’re complementary to each other, according to IHI improvement advisor
Even though he’s an advisor for the Institute for Healthcare Improvement (IHI), Richard Scoville, PhD, is quick to tell you that Lean management — or its related iterations in healthcare, Virginia Mason’s management system and Sutter Health’s adaptation of it — are really quite good. The rationale behind a white paper comparing Lean and the IHI management programs was really just to explain the two systems to people, not to sell folks on the IHI program at the expense of the other. There is, he says, plenty of room for both, and plenty of insight that each system and its adherents can gain from the other.
Scoville says it’s not a matter of either/or, but actually more "both/and because they are complimentary to each other."
Both are road maps to higher reliability, he says. What differs is "how they traverse the territory. We are trying to standardize a variable product — a product that is actually the producer and consumer at the same time. Creating an improvement model that works for that is difficult."
IHI is grounded in the work of W. Edwards Deming, while Lean grew out of the Toyota Production System and is often used in conjunction with Six Sigma. There are other management programs used in healthcare, as well, Scoville says. And in the end, it may not really matter what an organization uses, as long as it uses something as a guide. "Any map is better than none. Adapting one and getting people together to discuss change, whether it’s Lean, IHI’s Quality Improvement model or something else — it’s just a vocabulary, a jargon you can use to guide you on your path," he says.
IHI has set aside the notion of management system and focuses on processes, changing them when necessary and ensuring they are consistent. Lean goes further, Scoville says, by taking process changes and making them part of the daily work of staff. A checklist that is implemented as part of a QI project ends up being sustainable because it becomes embedded in the typical day of the CEO, the physician, and the housekeeper alike.
IHI’s method can also learn from the Lean technique of going to the source of the problem — visiting the shop floor or the front line — and getting to see work flows and the issues faced by workers firsthand, he says.
Lean, on the other hand, could benefit from the broad array of methods used by IHI, rather than being hemmed in by a specific methodology, he says.
Scoville says that what is good about both systems is that neither is static. As applied in healthcare, they continue to evolve and adapt, and there is no reason to believe they will do differently in the future.
For more information on this topic, contact Richard Scoville, PhD, Improvement Advisor, Institute for Healthcare Improvement, Cambridge, MA. Email:
[email protected]
