Book Review: Perfecting Patient Journeys

Healthcare is undergoing many changes these days which has long been overdue for those of us who have been patients.  Lean thinking has been spreading globally for decades in product and service businesses. In the last few years this value stream improvement methodology has been gaining support in health care.  Now there is a step by step guide for visualizing the patient experience and improving the flow of value with Perfecting Patient Journeys.

Published by the Lean Enterprise Institute (LEI) Perfecting Patient Journeys is a guide for leaders of healthcare organizations who want to implement lean thinking. Readers will learn how to identify and select a problem, define a project scope, and create a shared understanding of what's occurring in the value stream. Readers will also learn to develop a shared vision of an improved future, and how to work together to make that vision a reality.

The authors describe and advocate a value-stream approach to improvement bringing together both scientific and cultural components needed to transform Lean Healthcare.

The workbook comprises of 8 chapters which constitutes the steps of the improvement cycle:

• Team-based problem solving and learning for continuous improvement
• Scoping your improvement project
• Value-stream mapping – current state
• Future-state mapping
• Measuring the future state and planning for change
• Establishing project management
• Keeping your improvement project on track
• Moving forward- from projects and events to consistent practice

                            

The basis of the workbook was a field guide developed for support of training during collaborative sessions in a project with MHA Keystone Center for Patient Safety & Quality. Throughout the book the authors, who worked on the project, utilize their case study of St. Luke’s Hospital initiative to improve the performance of their emergency department as an example.  They include details of improvement from St. Luke’s that makes it easy to follow and implement this improvement approach.

While this workbook is intended for practitioners with direct interaction with patients it also helps senior leadership understand and support system level improvements. Written is a clear manner without excessive Lean jargon or terminology, this book presents the value-stream improvement approach, which simultaneously blends the ability to change structure and process while changing culture.

Perfecting Patient Journeys follows the style as other LEI workbooks but has a different look. This workbook doesn’t have the typical spiral binding of the other workbooks as it a hard cover book. Likely this was done to better market the target audience of healthcare professionals. Personally I prefer the spiral bound style for its convenience in the gemba or at team meetings.   

While the audience for this book is clearly healthcare workers it has easy application for any service process. This guide presents a method to sort through problems, establish priorities, and focus on solving the right problems with teamwork which is applicable in all processes. Lean practitioners and those alike interested in learning an improvement methodology based on eliminating waste within a value stream with teamwork will find this book a helpful reference guide.

Disclosure: My friends at LEI sent me a copy of Perfecting Patient Journeys for my review.