QUERI – Quality Enhancement Research Initiative

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Quality Improvement Methods

25. Lean Daily Management

a. Definition: It is crucial that Lean improvements be sustained. Having an ongoing Lean Daily Management System (LDMS), which generally consists of routine huddles (short meetings to share current status, critical priorities and plans), assures consistency, teamwork and the cultural change that often accompanies the operational changes. LDMS usually includes visual status displays available during the huddle (see Performance Board) and frequent contact between supervisors and staff regarding resolving problems and ascertaining status. It should be clear to members of management that their responsibility includes running their area as well as improving it.

Lean Daily Management involves determining current issues and fixing them immediately - with the team. Thus collaboration, promptness and continuing improvement are necessary. Each member is fully responsible for the team's success.

b. Literature:

  • Jackson, Thomas L. Implementing a lean management system. Productivity press, 1996.
  • Barnas, Kim. "ThedaCare's business performance system: sustaining continuous daily improvement through hospital management in a lean environment." Joint Commission Journal on Quality and Patient Safety 37.9 (2011): 387-399.
  • Hagedorn, Brittany. Lean Daily Management: A Tool for Engagement and Cultural Change, Hospital Financial Management Association Online Newsletter, June 17, 2013
  • Berlanga, Jerry. Lean Daily Management for Healthcare Field Book, Productivity Press, 2016.

c. Example: A facility has improved its function through the use of QI tools but needs to be sure that the change is sustained. A LDMS assures that improvements remain by keeping the necessary individuals involved and also is there to make ongoing improvements. By its focused and brief time requirements this support will be ongoing. Some hospitals have found daily stand-up departmental meetings at the start of each day helpful.

d. Steps: Like other improvements the addition of an LDMS can be implemented in an organized way such as PDSA (See Section 28) where it is planned, tested and modified as necessary.