Conference To Hear How Hospital Saves Time


    Conference To Hear How Hospital Saves Time (from This Is Lancashire)

    I'm sure they are doing good lean healthcare work at this hospital in the U.K.:

    THE boss of the Royal Bolton Hospital is to be the main speaker at a conference because of the hospital's “lean thinking”.

    Ten months ago, the hospital became one of only six in the world – and the only one in Britain – to introduce the idea to reduce delays.

    A Detroit newspaper article also insisted that the University of Michigan hospital was “one of the first” to use lean methods.

    It's not true, in either case — “one of six” or “one of the first.”

    I'm nitpicking, since an unknown and growing number of hospitals are using lean methods worldwide. What's important, for articles or conferences, is the RESULTS and the culture change. Whether you're first or not doesn't really matter much.

    The U.K. hospital has results:

    “Since the introduction of lean thinking at the Royal Bolton, the length of time it takes a patient to get from accident and emergency to the operating theatre has been reduced by 38 per cent.

    Paper work has been cut by 42 per cent and the total time patients spend in the hospital has been slashed by 32 per cent.”

    I am surprised that they measure the value stream from “accident” to the operating room. I hope they aren't encouraging the ambulances to be less careful about going through intersections in the name of reducing patient cycle time. Right measure (cycle time), but maybe not the right value stream boundaries? How about measuring it from ER door to operating room??

    “Total time patients spend in the hospital” can be reduced by discharging them earlier than would be ideal…. I guess my point is that, given this bout of cynicism, that you have to be careful with metrics to make sure they can't be gamed, to make sure you are doing the right things for the patients. THAT is one thing I'm not cynical about — hospitals have enough people whose job it is to make sure we do the right things for patients, metrics be damned.

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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. Hi Mark,

      Just a quick clarification from a UK reader: the measure you quoted is actually from ER to the operating room – in the UK we call the ER ‘Accident & Emergency’ or ‘A&E’ for short – so the measure doesn’t induce the ambulance driver to risk any more injury on the trip to the hospital!

      2 countries divided by a common language eh? ;-)

    2. Applying value stream design (i.e. lean) principles to healthcare is not new. Calling them “lean” is the new fashion – and it is therefore rewarding to be allowed to stick a designer label on our old clothes. Clinicians intuitively take a patient-centred view (i.e. value stream) but are often prevented from being able to make their patient streams flow by a lot of non-value added waste created by departmental operational policies imposed by non-clinicians. For example, in my clinic, six years ago we reduced the lead time from referral to decision-to-treat from 26 weeks to 2 weeks. It took us 10 minutes and cost nothing. How did we do that? We physically moved the ultrasound machine from the x-ray department (silo#1) to the outpatient department (silo#2) and then ran the clinic as a one stop service. It saved 1000’s of hours of wasted patient time and £1000’s in wasted administration costs. Last year I discovered that is a very Lean thing to have done. Cool – and I thought it was just common sense.


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