Lean in health care focuses on value to patients. It seeks to reduce waste, and to improve flow, quality and safety. The series of processes that link together to deliver a service to a patient or to an internal customer are termed a ‘Value Stream’. Thomas Jackson’s book ‘Mapping Clinical Value Streams‘ is a good introduction to the process of understanding and recording a Value Stream.
The book is a large format paperback. It is fairly brief, at just over 120 pages, but it covers a lot of ground. The structure is logical, and the author paces it well. Each chapter ends with a summary of the main points covered, and there are plenty of examples to give you a feel for the application of Value Stream Mapping in practice.
As with all books on Value Streams, it owes a lot to Rother and Shook. Having a book dedicated to the use of Value Stream Mapping in health care is useful, however, and it should be helpful for people who are put off by the industrial examples in other texts.
The advantages of a Value Stream Map are that it lets you display a whole process on one piece of paper, while also giving a good impression of how the system flows, and the location of queues, delays and waste. Martin and Osterling note that Value Stream Mapping is distinct from process mapping or information flow mapping, and Jackson makes the purpose of a Value Stream Map – to see an entire process at once – very clear.
Jackson explains how to describe the individual components of a process, and then to build these up to an overview of the whole system. There are clear descriptions of the ‘joins’ between processes: continuous flow, push systems, FIFO lanes, supermarkets and buffers are all covered well.
In addition to this, Jackson explains how these diagrams can then be used to help target improvement work. There is less on this aspect, but as the book is focusing on the development of the Map, this is understandable. He does emphasise that mapping for its own sake has no value: there has to be an improvement purpose to make it a worthwhile activity.
Overall, this is a good introduction to the creation of a Value Stream Map. The descriptions are good, and are mainstream accounts of the transfer of principles from an industrial setting to use in health care. If you want a health care – specific book on Value Stream Mapping, this is the best available.