Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) recently hosted the first-of-its-kind lean management conference in Dar es Salaam to share experience of implementing lean in a healthcare setting.

CCBRT was founded in 1994 to provide accessible and affordable community-based rehabilitative services to people with disabilities in the country’s capital. Over the last two decades, the organisation has expanded its services to other regions of the country, providing disability rehabilitation, clubfoot care, cleft lip/palate surgery, maternal health, obstetric fistula treatment, ophthalmology and other specialist services. CCBRT’s Dar-based Disability Hospital now serves hundreds of patients every day, and an Eye Outpatient Department that serves 250+ patients a day.

In order to meet the demands of a growing patient population, CCBRT began exploring a number of lean management strategies from 2011 in order to deal with high patient volumes, the associated long patient waiting times and congested waiting room space.

With support from the Human Development Innovation Fund (HDIF), a UK Aid investment in innovation, and guidance from the CEO of Catalysis (formerly ThedaCare), Dr John Toussaint, CCBRT has successfully implemented a number of key lean management initiatives and programmes that consist of on-going workshops and meetings to encourage a shift in work culture to improve efficiency, largely focused on major changes to their Eye Outpatient Department.

As part of their on-going commitment to lean management, on 27th and 28th February 2017 CCBRT hosted an event titled: ‘Lean Management: An Innovative Approach to Healthcare Management in Tanzania’. Over the two days CCBRT brought together almost 100 Tanzanian healthcare professionals and government representatives, including the Permanent Secretary at the Ministry of Health, Dr Mpoki Ulisubisiya, as well as other stakeholders from NGOs, Tanzanian health communities and the private sector to develop their knowledge of lean management and how to apply it to the local healthcare context.

The CEO of the Lean Institute Africa (LIA), Dr Anton Grütter, co-presented the event with the Founder and Chairman of Total Systems Development (TSD), John Allen. The internationally recognised duo introduced the basic principles of lean management followed by an overview of the stages required to implement a lean management system to achieve sustainable continuous improvement.

“It was a necessary event because it demonstrated how lean can be applied for improvement in public health. It was also an opportunity for CCBRT to demonstrate to participants how they went about introducing lean management in their workflow,” said Dr Grütter.

“It comes down to the basic message that lean management is not something that you can do on the side; to have a sustainable system you need to put the continuous into the continuous improvement. Essentially you need to develop people to be able to do problem solving in a systematic way. You also need a lean leadership style of management to hold the lean management system together. If the organisation isn’t able to institutionalise all of these levels then it’s unlikely that continuous improvement will be sustained,” concluded Dr Grütter.

Having successfully transformed their Eye Outpatient Department by applying lean management, this year CCBRT plans to start restructuring the rest of the Disability Hospital around lean value streams.

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