The solution had to include creating a system of care, Pinnolis says. The Lean methodology first promoted by Toyota seemed like the most promising avenue, and Atrius began adopting the methodology in March 2009. Lean management is a production practice that considers the expenditure of resources for any goal other than the creation of value for the end customer to be wasteful, and thus a target for elimination. Essentially, Lean management is centered on preserving value while decreasing the amount of work.
"We wanted to change the way we managed the practice and create a system based on that," Pinnolis explains. "In the beginning our physicians were almost all skeptics and wondered if it was another thing management was doing to drive the physicians crazy."
However, physicians are almost unilaterally on board now, Pinnolis says. In applying Lean management to the physician practice, Pinnolis and the other leaders had to get the frontline caregivers and other employers involved in problem solving and process improvement. Previously, upper management would address any problems that came up and pass the solution on down the line.
"That had not worked very effectively. With the new approach, we wanted to enlist the staff and their knowledge, expertise, and enthusiasm in this process of change," Pinnolis says. "Continuous improvement is a big part of Lean management, with people trying to improve processes and solve problems all the time."
This article appears in the December 2012 issue of Managed Contracting & Reimbursement Advisor Staff.