IOM Endorses Continuous Improvement, Lean

IT IS ONE OF THE IRONIES OF HEALTHCARE that it has taken the prestigious Institute of Medicine (IOM) more than three decades to fully recognize the necessary and essential role that continuous improvement and the associated disciplines of Lean, Six Sigma, and process improvement must play if the American healthcare system is to meet the challenges ahead.

On September 6, the IOM issued a report: “Best Care at Lower Cost: The Path to Continuously Learning Health Care in America.” In many ways, this report excoriated the entire American healthcare system for taking inordinately long amounts of time to learn about innovations and service enhancements developed by non-healthcare industries and introduce them into healthcare.

Of course, this is not news to you readers. Over the past 17 years, these pages have often highlighted how progressive clinical laboratories and pathology groups have been first to adopt and implement an innovation developed by another industry, with ready acceptance by physicians and patients. And, consistent with the IOM’s findings, despite tangible evidence that first-mover labs had raised the service and performance bar, few other labs proved interested in adopting those same innovations.

But now—at the highest levels of healthcare policymaking—the performance improvement worm may be turning. In its description of this report, the IOM writes that: “Achieving higher quality care at lower cost will require fundamental commitments to the incentives, culture, and leadership that foster continuous ‘learning’… and “The product of the committee’s deliberations, ‘Best Care at Lower Cost,’ …points out that emerging tools like computing power, connectivity, team-based care, and systems engineering techniques—tools that were previously unavailable—make the envisioned transition possible… Applying these new strategies can support the transition to a continuously learning health system, one that aligns science and informatics, patient-clinician partnerships, incentives, and a culture of continuous improvement to produce the best care at lower cost.” (Italics by THE DARK REPORT.)

To me, this message is unmistakable. American healthcare providers will be encouraged—and given incentives—to establish a culture of continuous improvement. This may be one reason why our upcoming Lab Quality Confab, to be held in San Antonio on November 6-7, is growing in size and participation.


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