"Leaner, but Not Meaner" – In a Hospital


    Leaner, but Not Meaner | workforce.com

    It's always nice to see a headline NOT using the cute (but usually inaccurate) “lean and mean” construct. It's especially nice to see it in the context of a smaller hospital, Meadows Regional Medical Center, an 87-bed hospital in rural Vidalia, Georgia.

    First off, the results:

    Since 2005, when Meadows Regional first applied lean operating procedures in its emergency room, the average length of stay for ambulatory ER patients has been cut by 44 percent. That in turn has led to a 10 percent boost in the number of ER patients who received care, a likely contributing factor to patient satisfaction scores that have soared above 90 percent.

    “Literally, all we've done is taken an established body of knowledge and applied it to a very high-cost, difficult environment,” Kent says, referring to Toyota's renowned principles of lean production.

    The improvements, facilitated by Georgia Tech, were a combination of employee ideas (from cross-functional input… an important element to help break down hospital “silos”) and more technical elements (such as electronic medical records and better patient “visibility” – in an electronic sense).

    “When people see improvements are possible, it changes their attitude about making suggestions,” Kent says.

    The culture of hospitals is for cost-reduction or process-improvement projects to get initiated at the top, and then get pushed down lower in the organization. It is a model that critics say often leads to projects dying before they can be implemented.

    “Our approach is to involve front-end people in coming up with ideas, so that they have some ownership of the lean process,” says Frank Mewborn, the project manager who facilitated Meadows' lean team. Mewborn is with the Healthcare Performance Group, a newly created part of Georgia Tech's Enterprise Innovation Institute.

    The “old” top-down model is more likely to be “mean” than true Lean efforts. Other than soliciting suggestions, it sounds like classic Lean analysis and process observation methods were used:

    Mewborn helped Meadows' employee team analyze every activity used when patients are admitted to the emergency room. The goal was to identify which processes contribute value to patients and which ones don't.

    Once wasteful processes were identified, the team's next chore was to devise a plan to reduce or eliminate them. Using the scientific method of learning, they also were instructed to analyze the potential impact before making any changes.

    Great stuff. More evidence that Lean works in hospitals. It's also more evidence that, when Lean is done properly, Lean is Lean. Involve your people, look at the process, identify waste, solicit ideas, have the management and leadership required to help persevere, and measure your results. Congrats to Meadows – I hope they are able to keep it up.

    Please check out my main blog page at www.leanblog.org

    The RSS feed content you are reading is copyrighted by the author, Mark Graban.

    , , , on the author's copyright.

    What do you think? Please scroll down (or click) to post a comment. Or please share the post with your thoughts on LinkedIn – and follow me or connect with me there.

    Did you like this post? Make sure you don't miss a post or podcast — Subscribe to get notified about posts via email daily or weekly.

    Check out my latest book, The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation:

    Get New Posts Sent To You

    Select list(s):
    Previous articleLean Elements in NCAA Hoops?
    Next articleUsing Lean and Cost Reduction to Counter Rising Materials Costs
    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. Good stuff, Mark. I hope the examples keep coming – we have a chance to improve healthcare delivery in America with these tools, and every time I see an article like this, it tells me we’re on the right track.


    Please enter your comment!
    Please enter your name here

    This site uses Akismet to reduce spam. Learn how your comment data is processed.