Magnus Lord on health care focus

Medicon Village

We sat down with senior advisor Magnus Lord at Sopwith Management, new Medicon Village member from 1 May with a desk in The Spark’s B2B section, to have his perspective on what has been and what will be.

According to Magnus’ web page, he is one of Europe’s leading experts in modern healthcare management. He holds three university degrees – Medical Doctor, Master of Science and a Bachelor of Business Administration degree. A former strategy director of The Lund University Hospital, Lord is now working as an international lecturer and coach for executive management groups, helping them to lead their transformations. He is the author of the book ”Befria sjukvården” (”Free Healthcare”).

Medicon Village (MV): Why name your company after a British First World War fighter aircraft?

Magnus Lord (ML): I hold a private pilot license and love these early aircrafts. In fact, I’m building an exact and flyable replica of a 1916 Sopwith Pup at home at our small farm, to fly from my own grass landing strip. It takes forever, but I’m in no rush. It’s the perfect relief to my work as a consultant in my own right. I use the company name more for judicial purposes, a reason why my web page’s address is my name.

MV: As a strategy director of The University Hospital in Lund in 2006 to 2010, you worked hard on going lean. Is Lean Production of relevance today?

ML: Yes, more than ever! During my years at the hospital, we started to implement Lean Service in healthcare as the first hospital in Sweden. I left as the hospitals in Lund and Malmö merged into one, since this according to me was going the wrong way towards more Economy-of-Scale thinking, not less. To cope with both present and future demand, healthcare must introduce modern management structures. The entire production paradigm will have to be changed – from the current, century-old industrial thinking to a modern philosophy based on respect for people. Instead of mass production we need to empower employees with the mandate to own, improve and control daily operations, focus on the patient journey instead of silos, and last but not least change to a trust based and positive leadership, leaving Command-and-Control.

MV: You sound a bit like Don Quixote fighting windmills with no chance of winning …

ML: Healthcare is one of the areas where it has been most difficult to break away from the ideas of industrial mass production taken from the American manufacturing industry in the 30s-50s. That doesn’t mean that it will always be that way. We see more and more opinion leaders making their voices heard in Swedish media, commenting on the problems of the present health care operations, presenting ideas on how to change. I might have been an early bird singing, but I’m not alone.

MV: So, what are the game changers to deal with the problems of our health care system?

ML: Mass production is not suitable for healthcare and its complexity. The excellent people in the healthcare sector are simply working in a bad system, which is constantly making it difficult for them. The responsibility for managing and developing the core business must be re-delegated to the care givers. The focus must be on the real purpose of healthcare – to ensure that the patient’s journey through care is as good as possible, both in terms of content and time. The few care units in Sweden that work in that way achieve phenomenal results. Like S:t Göran’s hospital in the Stockholm area, which despite dealing with one of the world’s oldest patients bases still make the care work. Adult psychiatry in Halland, which eliminated the queues. Other great cases are the sleep apnea investigations in Ystad, which reduced time to diagnosis from five weeks to one hour, and the ADHD investigations in Lund, which went from 4 months to 3 weeks. These are good examples of how an improved patient journey also increases efficiency and saves money, but it is unfortunately still in the backbone of many bureaucrats that if we are to save money, we must centralize. It becomes a vicious circle. Sweden is a world leader when it comes to quality and other results mainly determined by the employees but is almost the worst in the OECD when it comes to accessibility and work environment, which is decided mainly by the system itself.

MV: And what is your role in this process moving forward?

ML: I look forward to provide healthcare management with the thinking and tools they need to turn things right. I’ve lectured in basically all regions in Sweden, but now I plan to work in other ways, using e-learning to have more reach. The need for management knowledge in how to create excellent organizations in real life is huge. I hope I can produce ways to fill that gap, because we need change now.

MV: How come some hospitals seems to be near collapse with staff leaving and patients lining up forever, when you state that most hospitals aim at doing things differently?

ML: Aiming is one thing, doing is something else. The managers need to create the necessary structures to make it possible for the staff to take over and improve operations. Unfortunately, this far most managers haven’t received proper training on how to do this.

MV: What’s your opinion on private healthcare?

ML: The philosopher Prigogine had this idea that if a system is old enough and ingrown, it is easier to build something new to replace it. There are those who claim that the regions governing our healthcare system are there now, and that we must let private care replace parts of the public care. I don’t know what’s right or wrong, but for private care to play a serious role, it must take its share of on-call and training etc, and avoid cherry-picking.

MV: … and on the new hospital to be built in Lund?

ML: Based on all the knowledge we have about excellent operations, we must together do what we can to prevent the new hospital area from becoming the last monument of the old days. The present ”Blocket” is an example of mass production silo thinking that doesn’t work, with e.g. X-ray and the Central Operation Department in the middle as hubs, with patients being transported in from the periphery, negatively impacting the patient flows. The most specialized services and really expensive equipment must of course remain centralized, but they are an exception. The common services must be offered close to where they are needed to create fast and flexible patient journeys. The centralized silos is not something we want to see repeated in the new hospital. This change can only be successfully implemented if you involve all the experts, i.e. the staff, when you design the new hospital. This is my most important message to the management teams of Region Skåne: Do not try to design the new hospital yourself, without including the employees from the very start. If you create a successful system for doing that, you will save years of frustration and possibly hundreds of millions of kronor.

MV: Are you controversial in your way of criticizing the Swedish healthcare sector?

ML: Perhaps to some. But less today, when the tide is turning and mass production is going out of style, than 20 years ago. Just recently, using the modern thinking, Alingsås Hospital managed to eliminate all the queues to their surgery, and Nya Karolinska in Stockholm did the same for 82 out of their 88 surgery queues, after they restarted their successful Lean-initiative. Many senior healthcare managers say that they don’t need more proof that the old system isn’t working.

MV: Finally, how come you have three exams?

ML: I’m curious and couldn’t make up my mind on what I really wanted to do. Looking back, I have had great use of all three exams, working with re-organizing technically complex healthcare structures. That doesn’t stop me from still being curious. My grandmother used to say that I should become a priest. Future will tell if she was right.