Learning from Business

Using Lean Process Improvement to Enhance Safety and Value in Orthopaedic Surgery: The Case of Spine Surgery

Lean methodology was developed in the manufacturing industry to increase output and decrease costs. These labor organization methods have become the mainstay of major manufacturing companies worldwide. Lean methods involve continuous process improvement through the systematic elimination of waste, prevention of mistakes, and empowerment of workers to make changes. Because of the profit and productivity gains made in the manufacturing arena using lean methods, several healthcare organizations have adopted lean methodologies for patient care. Lean methods have now been implemented in many areas of health care. In orthopaedic surgery, lean methods have been applied to reduce complication rates and create a culture of continuous improvement. A step-by-step guide based on our experience can help surgeons use lean methods in practice. Surgeons and hospital centers well versed in lean methodology will be poised to reduce complications, improve patient outcomes, and optimize cost/benefit ratios for patient care.

Improving teaching assistants' orientation in a school of nursing: a lean approach

Newly hired teaching assistants (TAs) come to schools of nursing with varying levels of experience in academic institutions. Therefore, the orientation of TAs becomes important at a micro level (student instruction) and macro level (mission of the organization). We describe a Lean approach to strengthening TA orientation and reducing waste and inconsistency. Developed solutions and tools through the lens of quality improvement are discussed.