Lean Leads to Green, Which Supports Lean


Forgive me if some Texas pride comes through in this post, as well as some former-client pride. The clinical laboratory team at Children's Medical Center Dallas was featured in the peer-reviewed Medical Laboratory Observer for their combination of Lean and Green efforts in the piece titled “A LEAN laboratory ‘goes green'.”

The article highlights how building a culture of daily “kaizen” (or continuous improvement) led to staff members taking initiative on environmental and green initiatives, reducing waste and reinforcing the culture that lab leadership and hospital leadership is cultivating.

From the article:

But as many organizations have learned when they institute LEAN, they must truly adopt its philosophy and culture before they can enjoy LEAN's full benefits. With the recent initiation of an ambitious recycling campaign, the lab at CMC is reinforcing the main pillars of LEAN: the culture of continual organizational learning and improvement (kaizen) and the importance of challenging employees to use initiative and creativity to experiment and learn.

The lab at Children's has focusing on BOTH key pillars of the Toyota Way – kaizen and  “respect for people,” as shown in the article. As an aside (and I think this comes from the publication, I'm not sure why LEAN is put in all caps, as it is so many other places… it's not an acronym).

Are the cost savings and ROI huge, here? The savings from different initiatives are in the thousands and tens of thousands range. Nothing that makes or breaks the hospital budget, you'd suppose, but cultivating the climate where employees participate in improvement and they feel good about the contribution they're making to the organization and the environment – that's got to priceless and will lead to other innovations.

The lab focused on the R's: recycling, reusing, and reducing. The staff members challenged the traditional way of doing things, including this example:

The laboratory reuses paper by asking the hospital's copy shop to turn scrap paper into notepads. This idea has spread to other areas of the hospital. Also, the laboratory reuses the specimen biohazard bags by tubing them back to the floor once specimens are removed. To do this, the bags must appear clean and will not be sent to areas of the hospital with high concentrations of immune-compromised patients (e.g., transplant units).

In keeping with the spirit of not suboptimizing or not doing things that are unsafe, I'm sure that the decision around the re-use of bags was run through infection control, the pathologists, and other stakeholders.

The lab found that the Green initiative reinforced the Lean culture of kaizen.

The philosophy of continuous improvement within an organization is applied to CMC's laboratory green project in several ways. The LEAN Green Team has used the lab's kaizen board (see Table 1), a place where personnel can post ideas for improvement or show progress toward new goals.

The kaizen board had been in place before the Green work, but the approach for submitting and reviewing ideas applies here as well. This is a highly visual and transparent method from David Mann's book Creating a Lean Culture: Tools to Sustain Lean Conversions and adapted slightly in my book Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction), one that's very different than a traditional batchy “yes/no” suggestion box system.

I love the conclusion of the article:

Respect, develop, and empower employees. The members of the laboratory's LEAN Green Team have been given the power to improve the lab in ways outside of their job descriptions, and all employees can be involved and offer ideas for improvement. All laboratory employees are encouraged to add value in ways that provide both professional and personal fulfillment. One way to do this is to join a committee with a focus aligned with a personal interest, and the LEAN Green Team is an option if one is passionate about being green.

Finally, the LEAN Green Team asks employees to apply the concepts of recycle, reuse, and reduce outside of the work environment as well. For instance, one tip-of-the-week e-mail has suggested that employees try drinking filtered water in reusable containers instead of bottled water. When employees incorporate LEAN concepts like reducing waste in aspects of their lives outside of work, the culture and philosophy of LEAN has been reinforced.

The mission of Children's Medical Center is to provide the highest level of clinical care in an effort to “make life better for children.” By recycling waste, reusing supplies, and reducing the lab's energy and supply needs, the clinical laboratory is not only acting as a responsible steward of the planet, the employees are also fulfilling the hospital's mission. The LEAN, green lab provides outstanding service while also operating efficiently to save money that the hospital can use to serve even more children.

What's not to like?

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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. Waste is waste and lean thinking abhors waste. It is a great example, however, of how doing good for one’s self can also result in doing good for the community.

    I find it interesting that this is far more common in industries that do actual work and deliver valuable goods and services such as healthcare and manufacturing than it is in industries with pseudo-products such as “financial services.” (Read this idiot for an example of how they think http://bit.ly/bPvxhq)


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