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Lean is for Teams

Reading Robert Bruce in a UK Financial Times special report you could think management accountants were about to save the NHS single handedly.

His article cobbles the management accountant's role to a report published by the NHS Confederation on the application of Lean Thinking to the NHS.

Pioneered by Toyota, Lean reduces waste by challenging organisations to eliminate steps that don't add customer value and speeding up those that do.

The NHS Confederation report discusses the reorganisation of Pathology services at Bolton Hospital, which reduced test resulting from a minimum of 24 hours to between 2 and 3 hours and the need for space and staff. I have been impressed by the hospital's achievements, as I mentioned in another post.

I have experience of improving processes as a veteran of a hospital process redesign. Even if impressively named point Kaizen, optimising part of a process--such as Path--carries the risk of deoptimising the whole; for example, by creating a larger queue at the next bottleneck, say admission for treatment. Service improvement needs to be seen as a whole.

Similarly, improvements by Lean are certain to be the result of whole group of workers, particularly those who actually do the work: clinicians, porters, consultants and lab staff. After all, a key principle of Japanese management is "go and look". First-hand experience of processess if often invaluable in improving them. Nonetheless, I would weclome management accountants who engage in the operation of departments and who display skills in process mapping and measurement.


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