More on Lean Pittsburgh Hospitals


Private Sector: Safe hospitals

Here is another great overview of applying lean to hospitals, including a mention of the excellent DVD, “Good News… How Hospitals Heal Themselves.”

“First, we affirmed that striving for zero medical errors or zero hospital-acquired infections is the only tenable goal. Any outside benchmark or arbitrary target would not have pushed our experiment nearly as far as it went. And we can point to at least one hospital — Allegheny General Hospital — that got close to zero and sustained and spread its momentum to other clinical units and to other kinds of infection.”

Why don't most factories set a “zero injuries” goal? As in the quote above, isn't that the only goal worth shooting for? When I see factories with safety charts that show a “goal” of something like “0.027 lost work day cases per thousand hours worked” (or whatever the stupid number says), I always cringe. Sure, the goal is lower than last year's injury rate. But isn't the only ethical goal to be zero?

How does your factory or workplace set injury goals? Zero or something higher?

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


  1. In Pascal Dennis’s “Andy and Me” the first (maybe second) thing the sensei does is take a safety walk. And is many accounts of lean implementations, the first thing the people freed up from production are asked to do is to take safety walks.

    The biggest waste is hurting a human being – not “lost workdays.”

  2. Karen, if you were chastising me, you’re correct. I used the typical phrase “lost workdays” without thinking it through. That phrase is about as bad as calling people “bodies” or “heads.” Focusing on the lost workday considers only the loss to the employer, you’re right to focus on the human injury and human loss from the employee perspective.

    And also, I realize setting a draconian goal of “zero injuries” will sometimes force people into hiding injuries, as Deming wrote about in his books. You can’t just set a goal without working on the process behind the metric (the injuries).


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