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Lean Institute Africa Chairman, Norman Faull, visited Gauteng Health hospitals Charlotte Maxeke (CMJAH) and Leratong last week. He had this to say about his time there:

“It was an absorbing and inspirational few hours at each of these hospitals which are adopting lean principles in their striving to improve the care they offer. The improvement work is being done under the guidance of the CEOs, who are themselves receiving executive lean coaching from healthcare improvement centre, Catalysis, USA, with local support from the Lean Institute Africa. It was encouraging to see focused coaching improving work within the Maternity and Surgery (amongst others) at Leratong Hospital, for example.

Above: CEO coaching

“At Charlotte Maxeke Hospital (CMJAH) a very exciting initiative is taking place too, whereby a lean lens is being applied to the supply chain which supports the delivery of the correct medication to home-dialysis patients. There are currently 55 adult and 12 paediatric patients who are at home awaiting life-saving kidney transplants and who need support to undergo dialysis at home.

“The office workers involved in this supply chain have specific tasks to ensure the reliable monthly deliveries of this life-saving support. These people are all geographically separated: the finance and supply chain departments of CMJAH, the Gauteng provincial finance department, and the private sector medicine supplier are all necessary. But each person is not necessarily aware of the significance of their role in this chain. Prior to this lean analysis, the 10 different role-players involved in the supply chain have been working in silos, unaware of how essential their work is in supplying essential care to these very vulnerable patients who are dependent on them to receive the correct care. The repercussions to one part of the chain failing is potentially disastrous: Ambulances may need to be dispatched to patients, patients may need to be readmitted to hospital, the patients may then be too unwell to receive a kidney transplant they have been waiting on for years, and have to go back on to the waiting list, and possibly death. Processes going wrong within this supply chain have enormous impact.

“By applying the lean lense, this supply chain has been made visible, and reliability of supply now becomes more clearly based on the reliability of all the people involved in the chain. They now know that doing their particular role accurately and promptly is important to provide reliable care. What they are doing in an office now becomes so much more important: it is directly linked to reliable, timeous patient care. The people involved have had no introduction to lean, but have simply been coached by the CEO to get going on improving the system.

“As one senior finance person said of the existing supply chain (current condition): ‘The current system is perfectly designed to fail. We are determined to improve it and are excited at the way in which lean is enabling us to do that.’”

Above: Visual Management