Like Lean: Solving Health Care Problems By Design


    Solving Health Care Problems By Design : NPR

    Thanks to Andrew B. for passing this along – audio and web text from NPR with some concepts that might sound a lot like Lean.

    In an interview with the CEO of the design firm IDEO, Tim Brown, he tells the story of using visual management concepts in an emergency room:

    So one very simple idea – this was one of many ideas that got implemented – was each of the various people, the health care people in the emergency room: the doctors, the nurses, the charge nurses, the porters, we designed these very simple kind of uniforms for them to wear so that it was really clear who was who. And it even said it on big graphics on their uniforms, so that you weren't asking a nurse the question you might be asking a doctor or you weren't asking a porter a question you might ask a doctor.

    What really makes it sound “like Lean” is the engagement of the people doing the work.

    Well, this is where the participation of the people themselves that are going to change in the design of the new approach was key. And we see this all the time, don't we, in larger organizations, that when something's designed on the outside and then pushed into the organization, there's often a lot of resistance. But when you involve the people themselves, then they already own the new solution, and it's so much easier then to get the change to happen.

    That's exactly the approach I've tried to take with Lean in hospitals. This took me some time through my career to learn. When you're a young engineer, you're taught (or expected) to have answers. Lean is really about teaching others to improve their own work. So when I was consulting in hospitals, I would teach Lean concepts to the front line staff (like nurses or pharmacy techs) and let THEM figure out solutions. They own the solutions, they can sell the ideas and countermeasures to their colleagues. It's so much easier to make the change happen, like Tim Brown says.

    Tim Brown is the author of the book Change by Design: How Design Thinking Transforms Organizations and Inspires Innovation.

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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. Thanks for posting about this important idea and its relationship to Lean.
      In my experience this is the best approach for solving cross-functional business process problems. By teaching Lean to the front-line staff and then positioning a team to design a new leaner business process, you get the most precise solution, high adoption of the new tools and methods, and excellent post-project job performance.

      My company has been dedicated to this approach. I recently noticed the same ideas emanating from Ideo. Those who are interested can learn more by visiting my blog post "Hoshin Kanri Strategy Deployment, Product Development, and Lean Improvement Efforts" on The post includes another Ideo webcast link.


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