Lean in a Moose Jaw Hospital

Auto industry process revs up efficiency

No, not a hospital for moose — a hospital in Moose Jaw, Saskatchewan, Canada.

The Five Hills Health Region is revving up speed in providing mental health services and lab tests for patients — by applying principles used in auto manufacturing.

The hospital used value stream mapping to identify waste in the process:

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Lab staff tacked sticky notes on to large sheets of newsprint to create maps to identify how to cut in half the time a patient waited to have their blood taken.

They also recognize the lean concept that the people doing the work are best positioned to actually improve the process:

As a result, outpatients getting bloodwork done wait about 15 minutes instead of half an hour. Besides decreasing wait times for patients, the team approach has boosted staff morale, said Barb Flowers, the region’s director of laboratory services.

“All levels identify waste, but staff are the ones who can see that if I moved this over here, I’d save myself so many steps,” Flowers said. “It’s teamwork in that it is a bottom-up and top-down approach and management is moving toward more of a mentoring role to make sure that we meet standards and regulations.”

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Whether it’s for mental health services or traditional hospital settings, Lean methods work… if you’re willing to work at it and allow your employees to have some control over their process. The description of Lean being “bottom-up and top-down” reminds me of hearing John Shook talk about Toyota management being neither of those things (or being both of them). Lean leadership is definitely not the traditional dictatorial “top-down” method. Nor is it the “empowerment” model of just letting employees do whatever they want as long as they get the results you want. Lean leaders work WITH their people to define goals and standards, figuring out together how to meet those objectives.

Thanks for reading! I’d love to hear your thoughts. Please scroll down to post a comment. Click here to be notified about posts via email. Learn more about Mark Graban’s speaking, writing, and consulting.

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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.


  1. Ian Furst says

    I love the idea of the sticky notes on the newsprint. Creating the process flow map can be a bit of a PITA especially when you want to do it for multiple process’

    Great blog’s. thanks.

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