Lean efforts ignore top heavy health system

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The following is an open letter to Saskatchewan Minister of Health Dustin Duncan.

I write to you today to ask you to please reconsider your proposed "LEAN" program for our Health Care System.

I am a senior, born and raised in Saskatchewan. I have seen many changes in health and many other areas in this province over the years. I have paid my share of taxes, spent my working life in the health care field and, of late, have had dealings with the RQHR.

It is my believe that the problem with our health care system is not our health care workers. It is the result of a much too large leadership.

Compare the present system's organizations with a mushroom, with the front line workers being the stem. The front line workers being our nurses, doctors, diagnostic technicians/technologists, housekeeping, maintenance, dietary, etc.

The head of the mushroom consists of the administration staff. That will consist of directors, assistant directors, administrators, assistant administrators, dozens of committees, boards, CEO's, politicians, consultants, etc.

Over the years we have seen a huge increase in the size of the head of this mushroom without the subsequent growth in the steam and as we all know a mushroom that becomes too top heavy will inevitably topple over.

With the creation of multiple layers of management, you create competition in middle management for the approval of higher management (a.k.a. justifying their jobs) on who the units are being managed. I do believe that most people are starting to see that the bottom line of any aspect of the healthcare business is money. As in any business then, the goal of any good "manager" would seem to me to be to save the hospital money and it appears to me that this is most often being accomplished by creating committees and hiring consultants to figure out new ways to do this. This inevitably results in requiring the front line workers to "do more with less" or in the best case scenario, with nothing more. (asking the "stem" to carry more weight).

Is it any wonder that our actual working staff feel intimidated, threatened and defeated?

Does anyone ever question why morale is low on our hospital units? Why are there such things as code burgundy, gag orders, beds in the hallways being an acceptable way to spend a hospital stay, and on of the latest, co-ed patient rooms? Why can one unit not pick up the phone to talk to another unit with regard to patient placements or concerns, so it doesn't have to become a big ordeal? Why must such things have to go through an assistant to another director's assistant somewhere in the system? Isn't the biggest part of being "LEAN" to simplify processes?

Through our personal experience with health care we are still asking ourselves and members of the RQHR hierarchy, "Who is in charge?" "Who can make a decision and have it followed through in a timely manner?" We would love to know. Fifteen months after our "incident" we are still in limbo.

The easiest thing in the world is to blame the workers for the problems. These people get up every morning and go to their work, and do their best to do a good job for their days pay. How frustrating that must be when they see the problems but cannot voice their concerns in fear of reprisal. Remember the saying 'too many cooks spoil the broth', well perhaps too many bosses intimidate, frustrate and complicate the work place.

Surely we can fix our health system. I have to ask what other system, business, corporation, has so many administration employees? If all these people can't fix the problem then one can only surmise they are part of that problem. What a lot of good that $40,000,000 would do in the health care system working for those folks who paid it with their tax dollars.

Please put our money to use in our best interest and not in the pocket of some foreign enterprise.

Donna Byers - Maple Creek

Geographic location: Saskatchewan, Maple Creek

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  • Skeptic
    April 19, 2014 - 16:03

    To add to Ms Byers comments, one in 8 nurses is paid for entirely administrative duties. That is not "lean". Spending millions on over 1,000 of 10,000 total nurses, to do stuff an HR grad would do more efficiently, for less, is not "lean". Lean health-care means spending millions on administration and consulting. It means over 1000 nurses in the $100,000 + annual range ($100 Million a year!) for admin work. Despite all the anti NDP trash talk, Brad Wall is setting spending records by leaps and bounds in health care. He has supervised a 40 % nursing raise and ballooning of nursing admin numbers. His Lean system is not lean! Put the 1,000 + nurses back on the front line. And hire an admin grad for $50,000 rather than a senior RN (who just wants to avoid nights) for $100,000 a year to do scheduling, stocking and other low level admin duties. Shucks, you could get an MBA managing the ward for less than an RN

  • Skeptic
    April 19, 2014 - 15:56

    "Lean" is a scam. The government likes the "lean" name but it actually leads to increased consulting costs. Bit of an oxymoron, that the Lean system is not lean? The Sask Party has mindlessly jacked up medical school enrollment but has not added sufficient family medicine residency spots to accommodate the extra medical grads. So millions spent on more med students and hundred of millions on a huge new building to train them all... and they can't stay in Saskatchewan to do family med? Seems record spending Brad Wall has found another way, indirectly, to throw money at health care. Rather than directly adding family med spots. Rather than hiring more surgeons. Rather than hiring more nurses. Time to stop spending millions on Lean consulting that is not lean. Spend the money on staffing. Just another reason Saskatchewan continues to post deficits, despite record resource revenues.