University of Michigan Health System and Lean


    University of Michigan looks to lean principles for system-wide improvements –

    Here is some positive news coming out of my home state of Michigan… the U of M health system is a leader in Lean thinking for healthcare.

    The lean principles that revolutionized the auto industry are at work in the largest medical center in Ann Arbor, where teams of trained specialists and core staff have united to improve operations – and ultimately the patient experience.

    “The goal is to use lean thinking as a uniform business system for improving all aspects of what we deliver to our customers in all three of our key components,” said Dr. Jack Billi, associate vice president for medical affairs at the University of Michigan and an associate dean at U-M's medical school.

    These three components are clinical care, research, and education.

    Many of the prime Lean healthcare examples are from 200 or 300 bed community hospital type settings (including Virginia Mason and ThedaCare, two excellent organizations that are too small, sadly, to get the attention of the badly flawed U.S. News and World Report rankings – more on that later this week maybe).

    I often hear and see questions about “How does Lean apply in our academic medical settings? We also have to teach students.” Ok, then — if that's your purpose, Lean doesn't have to get in the way of that. As Jim Womack preaches: focus on Purpose, then Process, and People. If the purpose also includes research and education, then it's your job to figure out how Lean principles apply, so that's what U of M and other academic centers are doing.

    Dr. Billi (a great advocate for Lean) says:

    “(Our goal) is to use lean thinking as a business strategy for how we will accomplish … the best quality, highest safety, most efficient, most appropriate and best customer service that we can,” he said.

    He is emphasizing the point I often make that Lean is not just about speed and efficiency. It's just as much about quality and safety. In healthcare, “quality” can be broken down into clinical quality AND service quality – and Lean is proven to impact both.

    A bit of history about Lean at U of M:

    Lean thinking touched U-M in the 1980s and 1990s, Billi said, but it's been most active since about 2004, when it was chosen as the overarching strategy to tie the system's improvement goals together. U-M is one of about a dozen hospitals in the U.S. totally committed to the lean movement – including Saint Mary's in Grand Rapids – while many more are adopting aspects of it.

    U of M has a lot of Lean thinkers associated with the school, including John Shook and Jeffrey Liker, so it's no surprise that they were exposed to Lean early on (relatively speaking) — and they were also taught by GM and other automakers.

    How is their Lean effort structured?

    At U-M, a prioritization committee of top hospital leaders and employees from throughout the ranks determine what project will be tackled. About eight lean facilitators and 25 area coaches are “helping to guide transformation,” Billi said.

    The article has some other tidbits and quotes worth checking out, including how they reduced waiting times for orthopedic care from weeks to days…

    p.s. U of M is a member of the Healthcare Value Leaders Network (as are Johns Hopkins and UCLA Medical Center, two other academic centers).

    Subscribe via RSS | Lean Blog Main Page | Podcast | Twitter @markgraban

    Please check out my main blog page at

    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 articleReflections on Reader Feedback, Part 1
    Next articlePodcast Tables Turned on Mark
    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. Can you explain the benefit of being a member of the Healthcare Value Leaders Network? I looked on that site and don't see much content.

      -Public Relations reader

    2. Yes, our healthcare value leaders web site is pretty terrible at the moment.

      We are in the process of updating with more and better information.

      Email me at mgraban (at) lean (dot) org if you want info directly.

    3. I used to think that Lean was right for services, but some things never felt right.

      Then I discovered Professor John Seddon's podcast on ITunes and I realised where lean had gone wrong.

      ITunes > podcasts > search for The Systems Thinking Review > download and sign-up

      His podcast on rethinking lean service was astounding and explained why things never felt right


    Please enter your comment!
    Please enter your name here

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