Another Lean Healthcare Overview


    Squeezing the fat from health care –

    Here is another nice overview of some of the results seen from the application of Lean Thinking to the healthcare realm.

    One thing the healthcare people understand better than manufacturing folks is that you can't allow your lean efforts to be derailed by allow lean improvements to directly cause job loss.

    “In some cases, they fail because of poor implementation or lack of resources. In turn, workers get frustrated and fear job cuts as companies cycle through such management practices. Several hospitals, such as St. Agnes, do not lay off workers. Instead, workers are typically redeployed throughout the organization.”

    In hospitals I work with, the goal is to either A) grow “the business” by using freed up space increase the amount of work done by the same number of people (such as insourcing lab work that was previously outsourced) B) allow headcount to drop through attrition or C) redeploy employees to full-time lean efforts or to other departments.

    Since lean depends on getting employee involvement and participation, it's natural that the efforts would die off if people feel threatened.

    I toured two “lean laboratories” today, in two separate hospitals in the same major city. It's so encouraging to see that a lean lab gets great results (faster, high quality test results to patients) and that people are happy working there. Lean is not “mean.” Lean doesn't mean you pressure people or work them harder. Lean is about eliminating waste and making things EASIER. Lean labs are able to cut their cycle time (they call it “turnaround time”) by 50 to 70% by changing the layout, moving toward single-piece flow and implementing standard work and standard processes.

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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, one of the lessons I have learned in applying value stream design methods (i.e. lean) to healthcare is to get people on board by getting them to think how they are going to spend the time that will be freed up. Some want to spend it on doing value added work for patients that they can’t do now (i.e. increase quality); some want to re-invest in training to become multi-skilled (i.e. increase the resilience of the capacity); some want to invest the time in training others how to do value stream design; and only a minority opt to take the time out for themselves (i.e. choose to reduce their hours) or sit and do nothing. If freeing up time is only presented as a positive outcome for the staff then resistance to change is lowered. You won’t need to sack anyone (except those that are actively blocking the move towards higher quality, more rewarding and more cost effective services – the three wins – they are the ones you don’t want in the organisation – and the more of them you find and flush away with the rest of the non-value-adding waste the healthier healthcare will get!)


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