A Lean Healthcare Intro Video


A few weeks back, I was given the chance to preview a Lean Healthcare intro video from a Wisconsin firm called Optima. The video is part of their Lean Healthcare Video Series, called Lean: A Prescription for Healthcare.

The video can now be previewed online on their site or via YouTube. I've embedded the video below with my comments. Curious to hear, also, what you think.

Here are the video segments from YouTube:

Part 1:

Part 2:

Here is the feedback I gave. I think it's constructive criticism, so I'll share it here.

It was very professionally done and the tone and content were right for the audience. It's tough boiling it down to just 15 minutes, I'm sure.

I liked how it traced from tools to thinking and behavior, culture and management. Focusing on the need for “top down” is good (but also needs to be balanced with the staff engagement piece, otherwise, it's traditional command-and-control.. but I think that point was pretty clear, to my eyes). The emphasis on the culture of  continuous improvement  was good.

Focusing on how “change is hard” is a good warning (this isn't an easy silver bullet approach).

I  guess the constructive criticism points would be:

  • I'd have focused a bit less on some of the tools (like kanban) and more about how leaders and managers are really supposed to operate in a  lean system.
  • While quality was touched on, the emphasize of the video seemed a bit skewed toward the efficiency side. I'd rather see those in a bit more equal balance, since there'so much opportunity to reduce errors and patient harm, not just other types of waste.

What did you think of the video? If you like it, you can purchase it on Amazon:  Lean Healthcare DVD

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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. I thought it was a great video and good way to introduce Lean thinking to hospital staff and managers who have had little or no exposure to Lean.
    On the downside, I agree that a lot of these videos on Lean tend to focus on the the mudas that relate to efficiency and flow but not so much on ones like defects that focus on quality. This also leads to false perception that focussing on quality is not so much a lean focus. I wish the had focussed on how they have been able to create a culture of lean thinking.

  2. Mark, thanks for sharing the video. I’m especially pleased to see Affinity Health Systems featured as they are frequently overshadowed by their lean-focused neighbor in the Fox Valley.

    I liked the examples they gave, especially the new baby admission project. The examples help to make lean tangible and part of that is showing the tools in action. I percieve that the video is aimed for a general audience and for health care front line staff, so I am not as concerned as you are about the lack of focus on leaders and managers. I agree with you that quality and clinical outcomes should be given a little more emphasis.

    Finally, I’m disappointed to see yet another lean training session that ignores fully half of lean’s purpose and benefits: flow. The beginning of the video reviews the Eight Wastes, and toward the end the narrator describes lean as having a process and systems view, but the video doesn’t join the two concepts. Flow is an enormous issue in healthcare, but it is addressed only infrequently, like the elephant in the room that no one talks about (ED projects may be an exeption). Making matters worse, placing a heavy focus on waste elimination leads more often to isolated pockets of improvement rather than transformed value streams.

    Thanks again for posting the clips.


  3. Very nice video…I especially appreciated the efforts in creativity and humor. The transitions between the different segments of the video had good flow. Always great to see the testimonies from those involved in the success.

    My concern: When stating the definition of lean, the video said nothing of Respect For People. It mentions a commitment to continuous improvement and ends with lean being all about value to the end user. This is quickly becoming the status quo.

    I do recognize the constraint of limiting thoughts within 15 minutes; however, CI alone will not support sustained lean success…you need to include Respect For People. I looked on the website, hoping to find some mention, but could not find anything.

    Constructive encouragement: Optima has a wonderful opportunity to pioneer the COMPLETE establishment of Respect For People in lean healthcare. They have some of the benefits covered; better patient care, more time to spend with patients, etc. But what about benefits to fellow healthcare associates? Better working conditions and less stress. The customer is NOT just the patient!

    I do applaud the video, and it appears Optima is enjoying a good bit of lean success…keep it going!
    .-= Steve Martin ´s last blog ..Lean Gardening – Celebrate the Weeds =-.

  4. As someone who spent time in Japan and learned about Lean principles as they were introduced there it is interesting to see this new ‘version’ of these principles as they enter healthcare. Alongside the critiques here, I find it disturbing a) at a principle level and b) at an implementation level that the ideas around flow, quality and respect for people are ignored. I understand the dogma of efficiency but these three interrelated concepts ground the ideas of quality processes in the Japanese version. The improvement of flow is what leads to efficiency. Respect for people as it presents itself in ground up engagement and consideration of ideas and innovations into processes and systems leads to efficiency. Finally of course, these considerations alongside the time needed for quality leads to efficiency. It seems like in haste, either in video construction, or to catch the latest management trend, these essential elements are left out. We would do better, especially in health which also centers on these concepts, to pay them more attention.
    .-= laura ´s last blog ..Investing in Children: School Based Health Centers =-.

  5. Thank you for your feedback and constructive criticism, even though some of it was hard to read.

    I do have to say that this video was never intended to replace sound education and training on lean principles, only to supplement it. In fact, a facilitators guide and particpant workbook have been developed to go with the video to ensure proper dialogue and communication of lean principles base on Ohno & Shingo teachings. In regards to the comments on Respect for People, I think if you watch the video a couple of times that theme comes through…ie not blaming people, particpiating in improvement versus having it dictated…in this regard its not what you say it’s what you do!!!! Like respect for people. we did not leave quality out…baby’s staying in room with mom is quality, Docs and nurses having more time to spend with pts is quality…the facilitator needs to engage people in discussion and dig a little deeper into the story’s and concepts.

    Please put the video in contect of supplementing good facilitation to help create a learning environment and prepare people for the lean journey ahead.



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