Lessons from industry: one school's transformation toward "lean" curricular governance.

Area of Science:

• Medical Education
• Quality Assurance
• Organizational Governance

Background:

• Medical education faces increasing demands for centralized curricular oversight.
• Traditional horizontal governance structures present challenges to quality and innovation.
• Vertical governance models offer advantages but introduce new complexities.

Purpose of the Study:

• To describe a hybrid quality-assurance (QA) governance structure implemented at the University of Kentucky College of Medicine (UKCOM).
• To demonstrate how this model achieves centralized oversight while preserving creative control in curriculum development.
• To explore the application of Lean production principles to medical education governance.

Main Methods:

• Implementation of a hybrid QA governance structure at UKCOM in 2003.
• Adoption of a Lean production model, separating management (accountability) from production (decision-making).
• Analysis of similarities and differences between product manufacturing and physician education processes.

Main Results:

• The hybrid model ensures centralized curricular oversight of the educational product.
• Individualized creative control over the educational process is maintained.
• The approach facilitates continuous feedback on curricular quality through performance measures.

Conclusions:

• A hybrid QA governance model, inspired by Lean production, can effectively balance centralized oversight with educational innovation.
• Separating accountability from decision-making is key to managing complex educational processes.
• Robust performance measures are crucial for continuous improvement in medical curricula.