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Lean practices paying off at Legacy Salmon Creek

Delegation from Botswana visits hospital to learn about concept for saving time, money

By Aaron Corvin, Columbian Port & Economy Reporter
Published: May 10, 2012, 5:00pm
2 Photos
Charge Nurse Sandra Welker, left, leads a delegation of civic, health and government officials from the Republic of Botswana on a tour of Legacy Salmon Creek Medical Center's intensive-care unit.
Charge Nurse Sandra Welker, left, leads a delegation of civic, health and government officials from the Republic of Botswana on a tour of Legacy Salmon Creek Medical Center's intensive-care unit. Photo Gallery

You’ve had those days at work: Your boss doesn’t listen to your suggestions about how to do things better. The same problems keep cropping up. Nobody does anything about them. New conundrums pile up. Your time, maybe even the company’s money, is wasted.

Rewind. Repeat. Pull hair.

Your savior? Lean. Not as in exercising to shed weight and stress, but as in embracing a way of doing business that cuts waste, boosts teamwork, systematically tracks and fixes problems, and recognizes hard work.

It’s not a new concept. It doesn’t have a set definition. But “lean” management principles have taken root at Vancouver-based Legacy Salmon Creek Medical Center — where the concept is saving time and tens of thousands of dollars a year.

People are taking notice. In fact, a delegation of government officials from the southern African nation of Botswana visited the hospital on Wednesday as part of a tour of various sites in the Northwest to glean insights into and to share information about how to drive positive changes in an organization.

An estimated 31 Botswanans gathered inside a conference room of the Salmon Creek facility, where hospital officials, using a PowerPoint presentation, explained their lean initiatives.

Michael Boer, a process improvement engineer with Legacy — and one of several presenters on hand — said implementing lean practices isn’t about coming up with the perfect plan. It’s about planning and taking action, and then refining your approach as you go. Or, as he put it, “Let’s just give it a try.”

Pilot programs launched

Lean is most often identified with manufacturing or industrial operations, including efficient management principles pioneered by Toyota, the carmaker.

The idea is to relentlessly improve the processes that lead to getting things done by standardizing how you complete tasks, setting benchmarks to measure success and failure, and relying on empirical data — rather than intuition or pre-conceived notions — to decide what does or doesn’t matter.

It blends the scientific mind of an Albert Einstein and the fresh eyes of a child who’s seeing a particular piece of the world for the first time, said Boer.

And lean, which has practical implications for workplaces, families and schools, also has leapt from the confines of manufacturers to hospitals. ThedaCare in Wisconsin is a leader. So is Virginia Mason Medical Center in Seattle.

Legacy Salmon Creek Medical Center began looking at lean

practices in January 2010 as hospital leaders recognized they lacked a systematic approach to monitoring work processes and improving them.

Since then, the hospital has launched pilot lean programs, including in its intensive-care unit, food and nutrition services department and rehabilitation operations.

The programs hinge on a three-pronged approach: leaders who “live” the hospital’s lean principles; “visual management boards,” where key performance indicators are posted, and green- and red-colored boxes show what’s working and what needs to be fixed; and huddles — brief, periodic gatherings of leaders and employees around the visual management boards to make status checks and sort out ideas and issues.

Effective efforts

The effort is working, data show.

For example, the hospital has cut the time it takes to secure a bed for a patient who’s transferring out of the intensive-care unit by 50 percent. That’s enabled the hospital to more quickly move patients from the emergency department to the ICU.

And by gathering new information and using it in a more timely manner, the hospital’s food services staff have seen increases in customer satisfaction ratings and shorter wait times for customers.

Cheryl Forry, manager of the Salmon Creek hospital’s intensive-care unit — who also made a presentation to the Botswanan delegation — said the work hasn’t been easy and still goes on today.

“We had to sell it to our staff,” she said. “If people on the ground don’t buy in, it doesn’t matter.”

Putting lean practices into effect did not prompt any of the 362 layoffs Portland-based Legacy made recently in Oregon and Southwest Washington, including 30 at Legacy Salmon Creek, according to Brian Willoughby, spokesman for the Legacy Salmon Creek hospital. Those layoffs were the result of drops in Medicaid reimbursements and a weak economy.

Inside the hospital’s intensive-care unit, a visual management board includes more than just performance metrics, and green and red boxes. It also displays cards the staff has used to recognize good work.

One of them spotlighted an employee who’d detected an abnormal reading on a heart monitor. “Good catch!” it read.

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After he took in a presentation of the ICU’s visual management board by charge nurse Sandra Welker, Samson Modise, a leader in Botswana’s Ministry of Health, walked back to the conference room.

He said his country’s been good at coming up with plans but that it needs to do better at building the kind of teamwork that leads to sustained action.

Nevertheless, he said, he was energized by his experience at Legacy Salmon Creek.

“It’s a wonderful presentation,” he said.

Aaron Corvin: http://twitter.com/col_econ; http://on.fb.me/AaronCorvin; 360-735-4518; aaron.corvin@columbian.com.

Columbian Port & Economy Reporter