A Lean Change Agent's Move to Healthcare in Michigan


‘It's all about process': Saint Mary's Steve Palmreuter targets waste

Here is an article that might serve as an inspiration for those of you who are looking to make a career transition from manufacturing to healthcare. The linked news article features a former Herman Miller lean change agent who is now working for a hospital in western Michigan.

And in a manufacturing state such as Michigan, there exists a vast talent pool for hospitals to tap to learn how to squeeze waste and inefficiency out of every aspect of an enterprise.

I hope more hospitals realize what talent is out there right now, a great time to hire someone to help with your Lean efforts — getting started or bringing your program in-house after starting with consultants.

At Saint Mary's Health Care, Palmreuter spends much of his time finding and resolving administrative waste.

One of his early successes came in the pharmacy at the health system's Wege Center, which was having difficulty keeping up with the workload at certain times of the day. He worked with staff to optimize the delivery of drugs each day to patients and outside clients such as area nursing homes.

He also consolidated two automated dispensing systems into one, generating $240,000 in annual savings. The pharmacy also has been able to pick up more business from outside clients.

In the surgical services department, he helped staff get a better handle on managing the inventory of supplies and equipment. The net savings: $700,000 by reducing inventory.

Great things to be working on, eh? Those are great results. They cut costs AND increased revenue by creating capacity. Hopefully, that's a great reminder to everyone that Lean can help create growth for a hospital without requiring expensive capital expense.

There's one little thing that jumped out at me from the article. Granted, it's about Steve and his transition, but if you were in his shoes, would you be a bit embarrassed with the “he, he, he” focus on the lean expert in the article?

That focus in probably the writer's fault… changes like these in a hospital are most likely to happen when you have a learning partnership between the hospital staff and the change agent. Yes, there are some places where it says he helped and coached staff, but there's a lot of “he discovered” and “he found.” It's better when the staff discovers waste and they find opportunities and they can do that when you teach them Lean principles and leaders create time for them to participate fully.

Some of the least rewarding work I ever did was in a manufacturing company that wouldn't give the front-line staff time to work on improvement (hmm, that actually sounds like many hospitals). I was expected to “make them Lean,” which is going to be as effective or sustainable as getting the staff involved (as I was always able to do in my work with hospitals that were embracing Lean, thankfully).

That nitpicking (on the author of the article) aside, it seems that St. Mary's is lucky to have him, based on what Steve says in the article:

“It's not about just those home runs,” Palmreuter said. “What we really need to be doing too is stringing together a lot of base hits.

“How often do we walk right past that type of waste because we presume it's not that big, so we assume it's not worth our time?” he said. “We miss those opportunities every day because we just don't have the right culture in place.”

Lots of little changes, many small improvements — that's a key aspect of “kaizen” and lean. Not everything is a huge project, nor does everything even require a week-long event.

Congrats to Steve and the leaders and staff at St. Mary's. They are setting an example that, hopefully, more hospitals will follow.

If you're in that career transition (or looking to find a guy like Steve, perhaps), join the discussion at my free site http://movetohealthcare.ning.com.

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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. After your second quote you have this paragraph…"Great things to be working on, eh? Those are great results. They cut costs AND increased revenue by creating capacity. Hopefully, that's a great reminder to everyone that Lean can help create growth for a hospital with requiring expensive capital expense."I believe you meant without.

  2. Dear Mark,Steve is my husband and I can assure you that the "he he he" focus was most definitely the writer's doing. :) My husband is the most humble man on this planet and would never take 100% credit where credit wasn't 100% due. However, he worked extremely hard networking in groups and with individuals, all after work hours, taking time away from our family to do so, in order to break into this industry from manufacturing. I appreciate you giving him kudos for his work, as he very much deserves it. It takes a strong person to step way out of your comfort zone and cross over into unknown territory. I hope there are some brave souls who take on our US Government next. It seems to me that they could use all the "waste elimination" training they can get!!! :) Thanks for recognizing that my husband may not be an egomaniac after reading this article. :) The first thing he said after reading it was that he was going to approach his team and tell them that he stressed the "we" during the interview; but that was not what came out in the article. C. PalmreuterWife of the Great Waste Reducer, Steve Palmreuter :)

  3. Hi – thanks for confirming my suspicion that the writer inadvertently did that to Steve, making the focus all about him.I'm glad he went through the effort to break into healthcare and maybe (if he has time) he can mentor some others on my networking site.

  4. I'm sure he would love to do that, as he is an awesome teacher and loves helping others achieve their goals. :) Patience is his most valuable asset, as he has much more than the average human being. It's something I'm trying desperately to learn from him! Thanks, and please remember Steve if an opportunity he cannot refuse comes up ;) (Preferably out west somewhere! :)


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