Lean Healthcare in Toyota’s Backyard?


Article Link: Lexington hospitals building to be the best

This article talks about the lean efforts of some hospitals in Lexington, KY – about 30 minutes away from Toyota Motor Manufacturing Kentucky (TMMK), the Georgetown plant. Is this an advantage to the hospitals to be so close physically?

While Toyota is a major economic engine in the area, the article points out that the combined payroll of three area health systems (UK HealthCare, Central Baptist and St. Joseph) is about double that of TMMK. All three systems are in the midst of major space expansions. Lean can certainly make a difference in terms of patient waiting times and quality (attracting more patients in a competitive environment) and reducing labor and capital costs. But, is the physical expansion (and hiring) ahead of the Lean improvements? Seems like it might be.

Dr. Michael Karpf, UK's executive vice president for health affairs, says:

Karpf and his lieutenants compare UK's new health care approach to Toyota's “lean technology” for its car manufacturing: “We think we make a better product cheaper.”

Hospitals around the nation have turned to Toyota for inspiration on rethinking everything from emergency care to nursing routines and infection control.

This is true, that hospitals around the world (not just the U.S.) are looking to Toyota for inspiration. GM and other automakers have helped hospitals in Michigan – do the Lexington hospitals benefit from having Toyota in their backyard?

Many hospitals have been able to use Lean process and space improvements to scale back or eliminate the need for construction (including Delnor Hospital, cited in this USA Today article, who avoided an $80 million expansion).

[William] Sisson, the only CEO of the three who doesn't have a big new hospital currently in the works, deflects the idea that that might put Central Baptist at a disadvantage. “A building is not a hospital,” he says. “I don't worry about that.”

I love the comment that a building is not a hospital. A hospital is made of people and processes. In this era of health insurance reform, will the hospitals with the best results coming from the best processes win out financially?   Does anyone know if Central Baptist is using Lean to avoid expensive capital expansion?

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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. It is quite possible that Central Baptist is using Lean just to avoid the capital expansion in which case their lean transformation may not go very far. If there whole motivation is just to prevent capital expansion then they have not motivation to go beyond that. Hopefully they’ll take it to the next level but time will tell.



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