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Wednesday, 19 March 2014 15:12

More at stake for Wall gov’t than hefty price of Lean consultants

Written by  Matthew Liebenberg
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Over the past few years the principles of Lean methodology have become an important focus of strategic planning and management in the Saskatchewan government, but last week it was the hefty price tag of its implementation that became a discussion point at the provincial legislature.

Opposition leader Cam Broten raised concerns over the $40 million the government will be paying over four years to consultants from the United States to train health care employees in Saskatchewan to use Lean.
Over the past year, the Saskatchewan NDP has made seniors care a key focus of its criticism against the government’s health-care policies and the large budget for these consultants has become part of that discourse.
Broten compared this $40-million budget and the $3.6 million spent on travel over two years by the consultants with the government’s response to a long-term care review, when a $10-million urgent issues action fund was created. The submissions from the health regions for funding exceeded the amount available from the fund and the government had to turn down some of the items requested.
Health Minister Dustin Duncan emphasized this was only temporary funding that had to be shared between all health regions and that additional funding might still become available in the 2014 provincial budget.
Broten argued the government is ignoring urgent health-care needs on the front line while allowing the implementation of Lean principles to become a “cash cow” for consultants.
Premier Brad Wall defended the spending in the legislature. He emphasized the implementation of Lean will result in larger cost savings than the consultancy costs and a more efficient health-care system that delivers better results for patients.
Broten has acknowledged that the application of Lean principles in the health system can be useful, but it should be done more cost effectively. He felt the total cost of implementation will be higher than $40 million because health regions and other provincial health-care agencies also have Lean contracts.
The government’s commitment to better health care outcomes for Saskatchewan residents relies heavily on Lean to achieve quality improvements and cost savings.
In August 2012, the Ministry of Health entered into a contract with Seattle-based John Black and Associates to facilitate the deployment of the Lean-based Saskatchewan Health Care Management System.
The Lean concepts were originally implemented in vehicle manufacturing companies, starting in Japan. The principles to reduce waste and errors, to allow staff to do their work more cost effectively and provide a higher-quality result for customers have been used all over the world by vehicle manufacturers and it has also been successfully applied in other economic sectors.
In Saskatchewan, the goal is to use the consultants from John Black and Associates to train more than 800 health-care staff to use Lean. These staff members will in turn become Lean leaders in their own workplaces.
Other health care systems across North America have successfully used Lean.
For example, Virginia Mason Medical Centre in Seattle has received numerous awards for clinical excellence and Lean is used at Seattle’s Children Hospital and Winnipeg’s St. Boniface Hospital.
A key difference is that Saskatchewan is the first province in Canada to implement Lean concepts across the entire heath system.
The Saskatchewan Health Quality Council acts as the provincial Kaizen Promotion Office (Kaizen is a Japanese word for continuous, incremental improvement).
The various organizations involved with health delivery in the province are all part of the Lean implementation process, including the Ministry of Health, health regions, eHealth Saskatchewan, 3sHealth and the Saskatchewan Cancer Agency.
The challenges of implementing Lean principles will be amplified on such a broad scale. According to Deloitte LLP, the effective application of Lean in the health care sector can be difficult because it is a service-oriented industry and patient care processes are complex. The challenges of using Lean principles in health care were also highlighted in a paper presented in September 2013 at the 6th annual IFAC Conference on Management and Control of Production and Logistics.
This study by medical sciences faculty members from the University of Campinas in Brazil and the University of East London in Britain found the implementation of Lean principles can take a long time, for example the current Toyota Production System has been in place since 1945.
In most cases the development of Lean projects takes place on department level and the researchers found few examples where Lean has been introduced effectively across an organization. Other challenges are to get the full commitment of all staff and to maintain a new Lean-based management culture.
For the Wall government, the financial cost of implementing Lean practices is therefore far less important than the potential political consequences if this approach does not deliver on its promise.
Matthew Liebenberg is a reporter with the Prairie Post. Contact him with your comments about this opinion piece at This email address is being protected from spambots. You need JavaScript enabled to view it. .

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