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Widgets, Walking Sticks or Weddings?

Much debate is whirling around the issue of how best to bring the management of healthcare into the 21st century. But what is really astounding, is the lack of basic understanding of the nature of healthcare operations.

There is a huge amount that healthcare management can learn from manufacturing. The production of widgets can, with the right knowledge, be executed with the precision of a Swiss watch maker.

Driven by the capacity of either the production process or the market, some manufacturing is fast taking on the 21st century artistic aesthetics that Leonardo Da Vinci would be proud to put his name to, but how can this scientific artistry be applied to healthcare?

We can adopt Lean to reduce waste, we can adapt Six Sigma to reduce variation and we can bend and blend other proven processes to suit the needs of parts of the spider’s web. But, however well we adapt these, we can still never quite attain the system-wide understanding that these practices bring to a manufacturing plant. We need to find a way to bring the level of clarity of system-wide understanding that these practices bring to manufacturing, for healthcare.

No matter how hard we try, healthcare needs a broader tool to bring it’s failings into focus. We see some health facilities adopting and adapting distribution methodologies from the commercial world. But healthcare is not an ‘industry’ that can be set up as a series of distribution centres that can be a one stop shop for all that ails the human condition. A warehouse full of walking sticks in each area of population will not serve the needs of ambulatory folk with viruses. While many of the lessons learned from commerce do have a place in the management of healthcare, they cannot provide the panacea of cures needed to bring this sector into the 21st century.

The provision of healthcare is more akin to the planning and execution of a wedding. No two are ever the same. The guest lists contain enough variations to make the logistics of getting everyone to the right place at the right time and wearing the right attire a planner’s nightmare. The whole event takes on the character of the happy couple with their likes and dislikes being the driving force behind the planning of an intricate fleeting ceremony. With so many variables, it is a wonder that any of these complex days are ever successful. Not convinced?

Imagine that that wedding party are the sole responsibility of one person to locate, clothe, transport and rehearse. Now add the tasks of preparing the venue, booking the caterers, band and officials. Now imagine that the participants of the wedding are unfamiliar with the ceremony, the etiquette and even the country and language where the wedding is taking place. Each and every one of them has to be guided through the process from beginning to end.

A ridiculous scenario? Yes, I agree. Weddings work because people usually know what is expected of them. They participate by preparing themselves and getting themselves to the venue leaving the wedding planner to concentrate on the essentials.

So how does this relate to healthcare? Like a wedding, the provision of healthcare is a complex integration of services and actions by PEOPLE, not machines. It is their participation in the process that makes it work. It is a moving feast of action and interaction between people whose place on the map changes as frequently as the pattern oil makes in water.

This is why many of the rigid processes that are being adopted by service industries from manufacturing are not the complete answer to bringing services to the level of efficiency/effectiveness as manufacturing. But like many good detective stories, the culprits are staring us in the face all the time, so often we just don’t see them.

It is the people working in service industries that are the source of most of the problem AND the cure to the problems they face. Often they know what will and will not work. They have ideas that never see the light of day. But what provision do the management of these services make for these ideas and suggestions to be investigated and tested?

So what tools should healthcare give to its managers? Should they be ones that align the production from machines, align a complex distribution network or ones that gets the most out of people?

Healthcare is a SERVICE industry and service = people…………… It’s not rocket science!

Copyright ©2008 TOCH, Inc. Used with permission.

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