Software KaiNexus offers Lean an assist

Healthcare providers are quickly and enthusiastically embracing Lean process improvement principles to cut costs, become more efficient and enhance quality. But there's room for improvement even in the process of improving.

The best ideas don't necessarily flow from management and are just as likely to come from staff members on the front lines of patient care, such as doctors, nurses and technicians. “Those are the folks who have all the knowledge about where the inefficiencies are,” said Dr. Greg Jacobson, an emergency medicine physician and founder of a company called KaiNexus. “But they have no power or medium to change all that.”

KaiNexus' software allows employees at all levels of an organization to share ideas for saving money, generating revenue or improving patient care. Users access the platform through the web or a mobile app. Their suggestions are visible to everyone in the group and ideas can't be submitted anonymously.

“KaiNexus is built on this concept of visibility,” Jacobson said. “It's a big deal. The customers that keep score, you can see it in their data, they do a better job. People start to speak the same language around it.”

The company is used to its platform being compared to an online suggestion box but insists that its technology is much more than that. Managers implement less than 3% of ideas from a suggestion box but carry out more than 80% of ideas that are submitted through KaiNexus, Jacobson said.

“A modern, continuous improvement system is different from a suggestion box,” said Mark Graban, author of Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement and a consultant to KaiNexus. “In a suggestion box model, basically everything bubbles up to a committee. The kaizen model (the Lean philosophy) is based on local teams managing local decisions.”

In addition to the transparency the software provides, it's also designed to be a collaborative rather than a passive tool. Managers have a certain amount of time to respond to an idea and will receive alerts when they haven't done so.

“The speed in which you answer a new idea really matters,” Jacobson said. Otherwise, employees “get disenfranchised and feel like management isn't listening to them.”

Mary Greeley Medical Center in Ames, Iowa, has been working on Lean process improvement since 2009 and began looking for a project management tool about three years later. That's when it discovered KaiNexus.

It completed its first 100 Day Workout in January 2014, when it challenged about 100 managers to come up with ideas that would either cut costs or bring in new revenue. That exercise yielded $600,000 in direct savings—and closer to $800,000 when factoring in “soft savings,” such as people's time, said Karen Kiel Rosser, the hospital's vice president and quality improvement officer.

Mary Greeley previously used another software tool to manage ideas, but the platform didn't encourage the same level of involvement. “It was all driven top-down by management and we totally turned that upside down,” Kiel Rosser said. “We completely flipped the triangle.”

The hospital has now expanded KaiNexus to all 1,300 employees and recently completed another 100 Day Workout. Employees submitted 52 ideas for improvement, and 40 have been implemented. Although most of the low-hanging fruit had already been identified during the first Workout, savings still totaled $327,000.

“We're really asking the employees to solve the problem,” Kiel Rosser said. “Every employee in this system is connected to their leader and their department. The system tracks all that, manages all that and makes it easier to work on these things.”

To get the ideas flowing, KaiNexus encourages hospitals to think beyond just cost savings and encourage employees to come up with suggestions that improve the patient experience or even their own job satisfaction.

“Talking about cost is the least likely thing to get people engaged,” Graban said. “If you get people engaged in improvement, the cost savings follow. It's sort of a happy side effect.”

One employee at an endocrinology clinic, for instance, came up with the idea of notifying patients that the hospital had its own in-house pharmacy for filling prescriptions. The idea was touted as a way to increase the convenience for patients. Yet the suggestion generated $600,000 in revenue in the first three months after it was implemented.

Irving, Texas-based KaiNexus, founded in 2009, has 40 customers, two-thirds of which are healthcare organizations. It has raised $1.7 million from angel investors and has 10 employees.