Unlocking high levels of quality with Lean in the healthcare system

When it comes to the healthcare system we can find different approaches on how Lean can help companies or hospitals develop better and more efficient ways to handle its procedures and processes. There’s a company in Brazil that is striving for that: Dr. Consulta. I had the opportunity to talk to Larissa Pechtoll, Performance Specialist, about how Lean is a game-changer for the company when it comes to quality, culture and standardization.

Q: What is Dr. Consulta and what’s your role there?

A: Dr. Consulta is a Brazilian company with health units spread across São Paulo, Rio de Janeiro and Minas Gerais. It’s an alternative for those who don’t want to use the public healthcare system (SUS, which is known for long lines) and for those who have a private healthcare plan but are in a rush for an appointment with a doctor. 

Dr. Consulta offers appointments and medical examinations on the same day, combining accessible fees with high quality and speed. I work with the excellence and standardization program, defining procedures and units adjustments. 

Q: How is Lean applied inside Dr. Consulta? 

A: We have a huge focus on tracking our goals so Lean is directly attached to the fast-growing results of our company. Today, all employees regardless of their role have clear goals and a voice, so we apply Lean tools, such as PDCA, and adopt practices, like regular meetings, to engage and help them in this effort. 

We have daily meetings that take place in our headquarters and in all health units so that everyone is on the same page. Our key goals change regularly, so it’s essential to keep in touch with all employees constantly if we want to have reliable indicators. This way, if we detect something that’s not quite right, we can act quickly to solve the problem. 

Q: How vital is it to involve all employees at the Gemba?

A: The people management sector is responsible for showing all employees the best path to deliver results. We deal with people, so we have to be sensible to understand their struggles and keep a close communication channel with everyone, be it on-campus (the headquarters office) or off-campus (the health units). The employees know best what is happening on a daily basis, their biggest issues and what problems they need to be resolved.

By bringing people on-campus and off-campus together, all peers engage in the discussion of actions and processes to be improved. This way, we don’t have to convince anyone; all employees are already working together on changes and continuous improvement. 

Q: Do you see Lean only as a tool or is it a core component at Dr. Consulta?

A: I definitely see Lean as a strategic component of the company. If it wasn’t part of the core business, we would have areas struggling with each other to accomplish this or that goal. When this is intrinsic to the company’s culture, everyone benefits from common goals. If our culture is not something clear and natural, people don’t engage together. 

To ensure that Lean is something fluid and organic as it can be, we hear all our employees. For example, if we detect that a health unit has a 10% improvement in one indicator, we talk to them to understand what happened and how we can replicate to other units. This is a point of motivation for any worker who desires to be recognized. 

Q: What are the main challenges of deploying Lean in a company that grows so fast? 

A: Our biggest challenge is the alignment among health units and the headquarters. Through a program of excellence and standardization we can ensure the same level of quality in all units, with everyone on the same page regarding processes. By having standardized processes, it’s possible to perform real and fast actions of continuous improvement.

This way we can follow and measure all improvement actions, allowing us to constantly evolve in an integrated and organized manner. Standardization is also responsible for making bottlenecks visible, helping us to grow with stability and security. If each unit has a process of its own, we can’t understand which is the best option, so standardization always comes first. 

Q: What is your biggest advice when it comes to working with Lean?

A: The biggest advice I can give is to work together with your peers, shrinking the gap among roles and making it clear that we all belong to the same company and have the same culture. We have to build the people’s management area alongside the employees, allowing them to see the relevance of our goals, metrics and performance. 

Of course, the strategic planning and goals to be achieved are top-down but the best way to accomplish those indicators is through a collective construction of all areas. By doing so, we have a better engagement and bigger acceptance when changes appear, cutting conflicts and not having to try and convince people of what’s best.

Bonus: Question by Jefferson Gonçalves, Customer Experience Manager at Nubank

Q: How do you ensure a customer-focused treatment in every Dr. Consulta units? 

A: Quality is one of our top goals at Dr. Consulta. Currently, I’m responsible for the excellence and standardization program in which we track the health units to grant the same quality level. We also have a strong relationship with the doctors, because besides being our customers they are our main suppliers. In order to keep track of all doctors, we have evaluations and indicators to check their performance at Dr. Consulta.

If you speak Portuguese, you can check out the whole interview with Larissa Pechtoll in our Gemba Talks Podcast or on our page on YouTube.