"Open Wide and Say ‘Lean’"

By Dean Bliss (bio below)

At the recent Shingo Prize conference, I was reminded of the power of Lean. Not just because of the award winners, but because of a humble dentist who practices in Jacksonville, Florida. And who practices Lean like few of us can.

His name is Sami Bahri, and he has a practice with 3 dentists. He heard about Lean, and thought it could help his practice, which was experiencing scheduling issues, repeat visits for treatment, and other inefficiencies that were affecting his patients and staff. He read up on Lean – not just the usual texts, but many others, over 20 books in all. He looked at the tools – again, not just the usual ones, but many of them, including kanban, level loading, one piece flow, even SMED. And his results were astonishing. Not just the numbers (82% capacity increase for the dentists, 57% fewer visits by patients for a full mouth treatment), but the adaptation of the tools – many more tools than I had seen applied outside a factory environment.

His presentation on stage included a demonstration of flow – he had two dentist’s chairs set up on stage, just like in his practice, and he and his staff simulated the flow of patients and caregivers through the process. It was a show-stopping presentation. So much so, that when one of my friends from Productivity Press said that Sami wanted to meet me (I was one of the few healthcare people there), I hesitated, because I was afraid he might corner me on a specific Lean tool application that I may not have known as well as he did!

I learned a lot from Sami, and I was reminded yet again that the Lean most of us learned in the factory works anywhere. The tools can be adapted to anything. And the philosophy is the glue that holds it all together.

So when we hear from our co-workers or clients that “Lean is a factory thing” or “Lean doesn’t apply to us”, we can be reminded of Sami Bahri, the dentist who decided to open wide and say “Lean.”


Dean Bliss is the Director of Lean Improvements for St. Luke’s Hospital in Cedar Rapids, Iowa. Dean is responsible for leading the Lean management process at the hospital and affiliated organizations. He joined St. Luke’s in May, 2005, after a 25-year career at Rockwell Collins, an aerospace and communications electronics company.

In addition to his Lean knowledge, Dean gained experience at Rockwell Collins in areas including Finance, Human Resources, Information Technology, and Facilities management.

Dean has a BS degree in Business Administration from Iowa State University. He has spoken at numerous Lean conferences and seminars throughout the country.

Please check out my main blog page at www.leanblog.org

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Mark Graban's passion is creating a better, safer, more cost effective healthcare system for patients and better workplaces for all. Mark is a consultant, author, and speaker in the "Lean healthcare" methodology. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. His most recent project is an book titled Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also the VP of Improvement & Innovation Services for the technology company KaiNexus.

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