Speaking of Lean process improvement, it appears that the folks running hospitals in Madrid could use some help. Check out this article on smartplanet, entitled, "Madrid hospitals look to free beds." The lede:
Spanish hospitals are looking to speed up check in and check out processes, without cutting patient care.
So, officials from sixteen hospitals in the city are getting together to share ideas. The article notes that most hospitals do have programs and objectives geared towards greater efficiency, but that they are “siloed” from department to department and problems often feel a “domino effect.”
As everywhere, there are some cultural problems that can complicate the situation:
[B]esides emergencies, Spanish hospitals shut down Friday afternoon until the busiest time of Monday morning, often keeping patients there two days longer than necessary. After congestive heart failure, the most popular cause of a longer length of hospital stay is simply the fact they were admitted on a Friday.
The medical director of the private Madrid Hospital Moncloa, Carlos Zarco described some services of hospitals functioning on the weekends as a great idea, but essentially “imposible” and very expensive in Spain. He said that profitability would go down, but he does think departments like radiology should be open on weekends.
Claro, imposible. I think this is an example of focusing on the hardest solution, rather than redesigning every day work flows to eliminate waste and inefficiency. Instead of bringing administrators together to analyze the problems from on high, it is time for them to go to gemba and watch the obstacles and work-arounds that the front line staff face every day.