Manufacturing and healthcare may seem similar since they both aim at constant improvement. However, these two areas differ in the matter that healthcare focuses on people and their needs rather than on the product. Two contrasting trends of standardization and customization develop simultaneously due to the complex nature of healthcare. The use of standardized measures to treat people may seem inappropriate since people have their unique physical and psychological peculiarities. However, the application of the lean culture principles first developed by Toyota has demonstrated its positive effects for the healthcare system. At the same time, manufacturing and healthcare are different only to some extent, since the lean philosophy advocates the idea of staying focused on the customer as the key to success. Therefore, with adequate transformation, the principles of lean philosophy are expected to demonstrate promising results.
For many years businesspeople were fascinated by the Toyota Production System more commonly known as the lean culture. This model focused on constant improvement and quality rather than quantity. In the 1970s, this model outperformed the traditional US strategy that minded only the bottom line disregarding all the other factors (Markovitz, 2016). Since then, the imperative to improve became unavoidable for all the manufacturers around the globe due to aggressive competition (Markovitz, 2016). This philosophy is based on several principles, such as stating the commitment to continuous improvement, participating and not proclaiming, challenging people to improve, and allowing time for growth. It is also vital to focus on increasing customer value, learning from failure, minding the complaints, and driving away fear. The progress should be based on the Shewhart or PDSA cycle, which is plan, do, study, and adjust (Markovitz, 2016). These principles can fit any organization if correctly interpreted.
The close analysis of the lean model demonstrates no problem with using its logic for healthcare organization management. The use of the PDSA cycle, along with the nine principles listed above is beneficial for the healthcare system due to its natural pursuit of continuous improvement. However, the lean model aims at standardizing methods of manufacturing to avoid unacceptable variation in quality. Such an endeavor may seem inappropriate for provision of care since every patient is an individual with unique needs and preferences. Standardized methods in healthcare may lead to waste and deviation of outcomes among patients. Therefore, adjustment to the methods used by manufacturers is required to fit the healthcare industry.
Standardization vs. Customization
In modern healthcare, two seemingly opposing views on care provision develop simultaneously. Standardization is usually associated with the “one size fit all” approach to treatment. While it is clear that such an attitude to care provision is inappropriate since all people are different, further investigation is required to acquire a deeper appreciation of the phenomenon. In healthcare, the matter includes design, terminological, performance, and procedural standards, and utilization of these standards has statistically improved patient outcomes (Mannion & Exworthy, 2017). Customization is associated with the ability to vary these standards according to patient needs and preferences. Such alteration contradicts the standardized model, since procedural or design modifications statistically may lead to adverse patient outcomes. Therefore, the two notions seem to be unable to coexist, and further research is required to determine which approach is more beneficial.
Even though Mannion and Exworthy (2017) support their claim that standardization and customization are competing for notions with convincing logic, another viewpoint exists. Greenfield, Eljiz, and Butler-Henderson (2017) believe that these two phenomena are long-standing colluding logics. The pursuit of quality standards has generated evidence that individualized care may lead to better patient outcomes, and the attention to preferences can improve customer satisfaction. For instance, Catena, Dopson, and Holweg (2019) claim that the implementation of standardized solutions may lead to increased readmission rates and deterioration of quality of care. The researchers state that there are no universal solutions and that customized care can improve patient outcomes and decrease integration costs (Catena et al., 2019). In other words, the attempt to standardize care by transforming the latest evidence into practice leads to customization. Therefore, if the manufacturer’s aim to use standard methods is substituted with the pursuit of standardized performance or patient outcomes, the lean model becomes acceptable for healthcare administration.
The collaboration between standardization and individualization is a source of continuous improvement. Healthcare research tries to find a perfect balance between these two approaches to meet the needs of all the stakeholders. According to Markovitz (2016), the commitment to improvement is the central feature of the lean philosophy, which is widely adopted by industries. However, the progress is ensured by the development of people rather by refining guidelines and procedures. Therefore, it becomes evident that the healthcare system can utilize the manufacturing principles by training and improving the professionals. Since care providers are life-long learners by nature, this aspect of lean culture is already being used by healthcare systems worldwide.
Focus on the Customer
Today, one of the primary objectives of healthcare is to provide patient-centered care. In business terms, this is the focus on the end customers, their needs, and preferences. According to Michael Field, CEO of the Raymond Corporation, which was acquired by Toyota, the core of the company’s success lies in customer-first focus instead (Blanchard, 2016). The utilization of the nine principles listed in the previous sections and the PDSA cycle is needed to serve the customer. Therefore, the culture of constant improvement is required to meet the expectations of the clients. In healthcare, all the latest evidence and management techniques are to revolve around the patient, instead of trying to serve the government or the health insurance companies. Even though lean culture aims at benefiting all the stakeholders, patients should be considered a top priority.
The principles utilized by the manufacturers are applicable for improving the healthcare system. Healthcare organizations are to seek standardization of performance by transforming the latest evidence into practice. At the same time, customization of care may also be beneficial for improving patient experience and satisfaction. In pursuit of finding a balance between the two seemingly contrasting matters, hospitals are to create the culture of constant improvement through developing their personnel. Even though healthcare systems need to benefit all the stakeholders, clinics and other facilities should focus their attention on patients
Discussion Question 1
What do you see as the conflicts between customizing patient care to the needs of an individual patient and standardizing care based on research?
A.: In recent years, two parallel trends started to prevail in healthcare: standardization and customization. Standardization is usually associated with a bland “one size fits all” approach that treats patients based on averaged numbers and advanced statistics. The method may seem inappropriate for treating people since every person is unique and has his or her individual psychological and physiological features. Customization is usually described as treating an individual holistically with respect to patients’ particular values, wishes, and lifestyle (Mannion & Exworthy, 2017). There are four several apparent conflicts between these approaches to healthcare.
First, customized care allows patients to choose the treatment they prefer after introducing all the evidence, while standardized care references only hospital guidelines and regulations. Second, rather than treating diseases, personalized care cares for individuals with their unique mix of conditions and psychological peculiarities. Third, individualized care creates more opportunities for patients to express their preferences in the non-medical aspect of hospital stay in terms of food, furnishing of rooms, and others. Even though the two trends seem contradicting, healthcare organization are to find a balance between them to provide quality care.
Discussion Question 2
Discuss the concept of “waste” from the Deming perspective. How do you think it could apply to hospitals and other health care entities?
A.: William Edwards Deming is most famous for his research concerning quality improvement using statistics as the primary method for assessing efficiency. His focus on the quality instead of cost let Japanese manufacturers overtake many markets in the US (Khera, n.d.). He created an atmosphere of quality improvement and advocated the idea of constant advancement to achieve better results (Khera, n.d.). He believed that unacceptable variation in the quality of products or services creates waste. The generation of waste negatively affect work efficiency; therefore, Deming stated the waste reduction is central for improving the performance of any organization.
The concept of waste reduction is crucial for effective management of healthcare entities. The difference in the quality of care delivery can lead to decreased patient satisfaction. Such a situation may encourage patients to start using services of other care providers. Without adequate patient flow, hospitals will have to close down or find ways to adapt to the new situation. Therefore, avoiding the cause of waste generation is central for sustainable healthcare facility administration.
Khera, R. (n.d.). Edward Deming’s 14 principles: Business quality improvement. Web.
Blanchard, Dave. (2016). The key to success is staying focused on the customer. Material Handling & Logistics. Web.
Catena, R., Dopson, S., & Holweg, M. (2019). On the tension between standardized and customized policies in health care: The case of length‐of‐stay reduction. Journal of Operations Management. Web.
Greenfield, D., Eljiz, K., & Butler-Henderson, K. (2017). It takes two to tango: Customization and standardization as colluding logics in healthcare. Comment on “(Re) Making the Procrustean Bed Standardization and Customization as Competing Logics in Healthcare.” International Journal of Health Policy and Management, 7(2), 183-185. Web.
Mannion, R., & Exworthy, M. (2017). (Re) Making the Procrustean bed? Standardization and customization as competing logics in healthcare. International Journal of Health Policy and Management, 6(6), 301-304. Web.
Markovitz, D. (2016). The fit organization: How to create a continuous-improvement culture. Web.