Simulation and lean are approaches that are rarely discussed together, particularly in the healthcare context. This is surprising given that they have a similar motivation: improvement of processes and service delivery. Given the current focus on the efficiency of health services there has certainly been a growing interest in both simulation and lean.
For lean there has been a rapid increase in its implementation in healthcare over the last decade, just over 50% of hospitals claimed to be using Lean methodology during 2007/08. However 'how' Lean is implemented varies greatly amongst Trusts and tensions of finance and accountability amongst others create significant complexity in relation to Lean implementation.
The concept of SimLean was developed in collaboration with four hospital trusts implementing a 'Lean programme'. Around 50 interviews were conducted and feedback collected from hospital staff around the potential use of simulation as part of an improvement workshop. When participants were asked how they thought simulation might be used alongside lean, perceptions generally fell into two categories of use: ‘an interactive and dynamic process map’ bringing the process map to life; and a ‘what-if’ scenario tool for experimenting with process configurations and testing proposed changes.
Some medical consultants expressed their dislike of process maps drawn on brown paper and post-it notes.
‘A computer simulation using real data would provide you with a dynamic process map and I have to say a dynamic process map would give me more of an understanding of a process than someone putting yellow and green post-its on a brown bit of paper on a wall.’
In acknowledgement that classic simulation games (often involving Lego bricks) were effective in delivering learning with regards to the principle of one piece flow, SimLean Educate was developed as a distinctive subset of SimLean to demonstrate the same principles in the context of healthcare and in a more rapid manner (30-45 mins compared to 3-4 hours for a typical Lego game).