Piotr Semaniuk is a Lean and Six Sigma specialist in Western Poland. For nearly 15 years, he has worked at large manufacturing operations such as General Electric and WABCO training employees there to minimize waste and add value to their work. But in a slight shift of focus, Semaniuk is now determined to bring the benefits of Lean thinking into the Polish healthcare system, and is using Friday Night at the ER to help him do it.

Piotr Semaniuk

Not surprisingly, the impetus for his new interest in Lean healthcare was his own experience at a Polish hospital. He had taken his young son in for arm surgery, and was struck with how overworked the staff was. The nurses seemed scattered and demoralized, and it affected everyone on site. As a Lean expert, Semaniuk knew that every patient interaction represented an opportunity to cultivate value for the patients, their families and the care providers themselves, but the opposite was happening.

“If you could have seen these people,” he explains, “they were tired, they were frustrated, they were a little grumpy, even shouting a bit. There were a lot of emotions.” Yet rather than blame the individuals treating his son — who did receive adequate care despite the situation — Semaniuk recognized their poor morale as a symptom of a broken system and set out to introduce the benefits of Lean thinking to hospitals.

He is now launching his own boutique consulting firm aimed at advising hospitals and other medical practices how to use Lean principles to improve patient satisfaction, staff morale and care outcomes while reducing costs, and Friday Night at the ER is central to his efforts. We talked with Semaniuk recently about his passion for Lean, how the game fits into his practice and how it may even set him apart from other Lean consultants in Poland.

Q:Piotr, the concept of Lean management is often misunderstood when applied to healthcare. Some see Lean as a euphemism for controlling costs, but this is far from the truth, right? Can you provide a quick overview of Lean healthcare?

My understanding of Lean healthcare is that the goal is to provide the most value from the perspective of the patient while consuming the least resources. It’s about creating the right environment for employees to engage in solving everyday problems. If done correctly, it will lead to continuous improvement of business results, shortening of process lead times and increased patient satisfaction.

Q:Lean healthcare is a relatively new concept globally. How receptive is the Polish healthcare system to adopting it and how is this affecting your practice?

We’re also starting on our Lean healthcare journey and I can see that we are slowly gaining momentum as there are already some promising initiatives both in private and public sectors. What is important is that there is a clear demand to improve specific processes. On the one hand, Lean (being a new concept for healthcare in Poland) might need some time to be introduced and embraced, while on the other hand, there are already identified problems that need to be solved and help is more than welcome.

Q:What traits do hospitals need to succeed at Lean healthcare?

First they need to see the big picture and recognize the connections and dependencies between departments. Then we should ensure effective and efficient communication and collaboration. From there I’d focus on developing problem-solving skills. I’m aware that this may be just the tip of the iceberg, but I strongly believe this is the right starting point.

Q:Lean involves aligning leaders and staff around a shared vision of continuous process improvement. How can Friday Night at the ER help with this?

Friday Night at the ER plays an instrumental role in allowing people to experience the results of their decisions and mental models. Not only does it help people learn a new approach, it also opens the discussion and connects people. It’s amazing to observe people from different departments unite and strive for the same cause right after the game. I can safely say that without Friday Night at the ER, it would take me significantly longer to explain the Lean concepts and (more importantly) to convince them to take action.

Q:When people play Friday Night at the ER, they learn to take a system-wide view of their work in order to make a positive impact on the system as a whole. How important is systems thinking to the implementation of Lean healthcare?

Nearly everyone who begins their journey with Lean focuses at the beginning on the tools and techniques like 5S, Value Stream Mapping or Kanban. With the first projects, you learn quickly that some improvements don’t last, and others don’t even get to the implementation phase. When you reflect on what didn’t work, you learn that everything is connected and that you need to look at the situation from a wider, system perspective.

Q:Have you ever used games or simulations in your work before? How are your new clients responding to Friday Night at the ER?

Yes, in my Lean Overview training I used the Beer Game a lot. I also developed a couple of simple games myself. Everyone who plays Friday Night at the ER loves the gameplay and the debrief. It delivers an eye-opening portion of knowledge and it’s an amazing way to engage people in the discussion. I don’t need to mention that it’s great fun to play.

Q:Playing the game can be transformative for participants. What are the most common ‘aha!’ moments you see when you lead game sessions?

Everyone has their own key finding that they’ll remember most. For some, it’s the moment when they realize they didn’t ask for data (but other groups did). For others, it’s the lack of joint strategy or lack of collaboration, but most of the participants focus on innovations they didn’t bring to the gameplay. I think most of them consider this as the most valuable takeaway.

Q:Our game kits come with a standard debrief. How do you plan to customize it for your work with Lean healthcare?

I haven’t decided on the final version of it yet (I usually fine tune the material after each session), but I will definitely add Lean materials on problem solving, value flow and communication to the debrief. I also need to consider adding enough time for discussions to ensure the right understanding of each of those modules.

Q:What impact did Covid have, if any, on the implementation of Lean healthcare in Poland and how is this affecting your practice?

Due to Covid, all hospital trainings / visits were cancelled. We’re now slowly coming back to regular meetings. If it wasn’t for Covid, I’d be at least one year ahead with some workshops. But nothing is lost – every day is a good day to start.