Th is medical centers case highlights the importance

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Th is medical center’s case highlights the importance of correctly positioning Lean to be successful: Alignment: Align Lean with the organizational goals, and engage physicians so they are on board. Leadership: Make support of Lean by hospital leaders visible to frontline staff. Team membership: Include multidisciplinary teams in Lean projects. Resources: Ensure adequate staff time, data, information technology, and Lean expertise to implement and sustain Lean projects. Communication about Lean: Ensure communication about changes resulting from project occurs. Staff engagement: Include physicians in Lean projects, while ensuring openness to multiple staff views.
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100 Exhibit 3.3. Characteristics of Grand Hospital Center Factors Characteristics Organizational experience with Lean Some experience Geographic location South Regional density Large urban Type of hospital Tertiary care center Hospital beds 214 Teaching hospital Yes Physician employment model Staff Use of an external Lean consultant Yes Exhibit 3.4. Complementary Leadership at Grand Chief Executive Officer (CEO) Chief Administrative Officer (CAO) Academic Medical Center Radiology: Clinical Lead Radiology: Administrative Lead Infectious Disease: Clinical Lead Infectious Disease: Administrative
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101 We've got huge waste in health care, prices aren't that good, prices may go up, but there's not going to be any more money for us going forward. The only way we're going to survive in an era of declining reimbursement is to lower our costs. The way you lower your cost is to take out waste .” Executive leadership Other Environmental Context Local Competition Grand operates in a competitive market. The CEO described local competition as greater than national competition; however, he noted that his medical center competes with large hospital systems in the region (South) and beyond it. The CEO indicated that Lean may make the medical center more competitive in this market by reducing the cost of care. Funding and Payers Grand’s largest payer is Medicare, accounting for 52 percent of payments. Further, given the large population of older residents in the State and the importance of Medicare as a payer, it is critical for Grand to deliver care at or below Medicare reimbursement rates. One interviewee noted that with limited resources, shrinking reimbursements, and an aging population, if Grand cannot provide quality care at Medicare reimbursement rates, it will not survive. Local Resources An important aspect of the context for Lean adoption is the availability of local expertise. In 2009, Grand joined a Lean consortium, which is a cross-industry group of more than 50 area organizations that are implementing Lean. The group collaborates to improve the performance of businesses and organizations applying Lean methods and tools, so they may become more efficient, profitable, and competitive. Grand is the first health care delivery system to join this consortium. Through the consortium, it has access to resources for Lean projects (e.g., seminars,
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