Lean Health Care? It Works! (Still)


IndustryWeek : Lean Health Care? It Works!

Here is a piece from 2003, still incredibly relevant. There is a great story of how lean methods, implemented properly, are good for all stakeholders — the patients, doctors, other employees, and the hospitals in general.

At the Community Medical Center in Missoula, Mont., Orthopedic Surgeon Doug Woolley was frustrated. A bottleneck in the recovery room limited to four the number of total joint replacements he could do each week; he figured he had time to easily do one more.He asked Cindy Jimmerson, a nurse turned medical researcher who works with the hospital to implement lean, for help. “So we did our observation,” says Jimmerson. “We observed very good nurses working very hard and saw a bunch of system problems — little tiny things that they work around without even thinking.

“We found three or four things that were not too big that we could [improve] — things like posting somebody's beeper number in an obvious place, so they didn't call somebody else to call somebody else. We made those changes very quickly and tried them out the next Monday.” The result? They reduced time in the recovery room from 90 minutes to 62 minutes. “Over four patients that gave us two more hours, which was more than enough time to recover another patient,” says Jimmerson.”

As Deming always told us, the last thing we need is everybody doing their best and working their hardest in isolation. Instead of fighting problems and instituting workarounds (“where is that phone number again???), we need to fix systemic problems. This message reinforced in the DVD “Good News… How Hospitals Heal Themselves.”

I have seen this so many times in my year in healthcare — people are trying their hardest, but they only know fire fighting and bandaids or workarounds. Teaching them how to solve root causes and creating an environment where problems can be fixed for good is very powerful.

It's a long article, but please take a look. While the healthcare world is learning a ton from the manufacturing sector, I would really like to encourage folks in the manufacturing world to read about and learn from the good lean hospitals and lean healthcare stories out there. Share the ideas and lessons with your colleagues and see how it inspires you to lead lean efforts where you are.

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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. Lean Mind

    From about 3 years ago I have been participating in a mind role training program that helps people to find their roles, images and behaviors in real life. And find their own VALUE in their life. As I know these programs is a branch of psychology called antealogy (self – training).

    In these training programs one person finds his own VALUE that in his past life he had it and makes new VALUE in his life as his potential in life. The opposite side of value in human being is called FEARS (MUDA)
    Fears make resistance of change in every body’s life. Most of our fears come from our past and they are different from one person to another one because of their different life. Main parts of our fears are come from our childhood and our parent’s behavior. So to eliminating our fears we must discover the points that fears are come! (Zero Quality control approach)

    I really have experienced these trainings and also have discovered some of my fears in my life. And I have eliminated some of them. And I have replaced my Values instead of FEARS. I think it is possible to go toward LEAN MIND


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