Lean Hospitals Book Survey — Do You Have a Name for Lean?


As I was researching and writing my book, I conducted an online survey (non-scientific) about hospitals and their experiences with Lean methods. I am going to be sharing some of the summary results, as well as some specific responses (keeping the respondents' information confidential).

If you took my survey and signed up for the mailing list for my book, you'll receive a full summary of the survey responses, or stay tuned here. I'll be publishing small bits and pieces over the next couple of months.

Question #4 from the survey:

Do you have a hospital wide name for your Lean efforts (such as “Hospital Name Production System”)? If so, what is it?

Right about 50% of respondents said “No.” The free form responses included:

  • Patient Flow Project, Administrative Project is not yet named
  • SPPI – System for Productivity and Performance Improvement (pronounced like “spy”)
  • Process Improvement
  • Process Improvement
  • Operational Excellence
  • Lean
  • Quality Plus
  • The [University] Quality System
  • Performance Improvement or Performance Excellence
  • Process Excellence
  • Vision 20012
  • [Health System Name] Performance Excellence System
  • Lean Resource Center
  • Building Better Care
  • Just ‘Lean Six Sigma'
  • [Hospital Name] Production System
  • Business Process Improvement
  • Customer Value Improvement Process

In my experiences with hospitals, many wish to put “their own stamp” on the approach, creating a sense of something that is being created within the hospital rather than something that is being adapted from the outside.

At the same time, organizations need to be able to share some amount of common language and appreciation of common methods that are used across hospitals. In some cases, the word “Lean” is used within the hospital's process improvement leaders, but the term is not used widely with hospital staff.

There is often fear of connotations that the word “Lean” might bring. Lean sometimes seems to imply “cuts” — in budgets or people — although Lean thinkers would realize these are not the goals of a true Lean implementation.

I think there are no blanket correct answers to this general question — do we call this “Lean” or do we call it something else in our hospital? It's typical for a hospital to develop a name, such as ThedaCare Improvement System or Virginia Mason Production System, once Lean has taken hold at more than a departmental level.

What are your thoughts on this, either for hospitals or in other industries? Feel free to add your comments here on this post.

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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. Using ‘lean’ has too many connotations. Somebody was telling me that Womack and Jones….regret using the word ‘lean’ now as it can give the wrong message.

    Tom Morgan
    Lean Evangelist

  2. I asked Womack about this and he said something like “Lean is just a word” and that it wasn’t that big of deal… so I don’t think he really “regretted” the word.

    I agree there *can* be negative connotations, but it’s the job of leaders to help create positive associations through their words and actions.

  3. Mark,
    When “The Machine…” came out a Google of Lean would have gotten you lots of Hard Body and sexual oriented hits (I know because I tried). Now it is all operations management stuff so Jim and His crew have had a big impact on how the word is used in many cases. It is as Jim said, just a word and words change meaning over time. The problem of Lean having a bad connotation comes from poor management techniques that miss the concept of TPS (The original meaning of Lean as Jim used it).

  4. Mark, I think you ask a very valid question with using the Lean word or what Hospitals call their major initiatives. It has been my experience in healthcare environments that many hospitals like to take the mainstream concepts and practices and create a sense of ownership with them and thus call them their own name. I don’t see anything wrong with that as long as the end results meet the goals and objectives of the initiative.

    On the other hand, I have a client that has a very active Lean program but the focus of the lean program has been in the supply chain and more specifically leaning out the Supplies to Meet the Demands of their various departments. So when they ask the question, has this department been “Leaned Yet” they all think of inventory and logistics as their “Lean Process.” I don’t see anything wrong with that because that is their focus right now and It would be my hope that they realize that they got a great Lean process that can be expanded into more areas such as service excellence.

    Great topic for discussion!


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