My Article in “Hospital & Health Networks” on Waste in Healthcare


After last week's piece on “putting the continuous back into continuous improvement,” I had another article published this past week.

This new article was published in the publication “Hospitals & Health Networks,” co-authored with Rob Harding, and it's called “Cut Costs by Reducing Redundant or Inefficient Activity.

I'm not totally crazy about the use of the phrase “cut costs” in the headline, but sometimes you have to get the attention of readers. And, after doing so, I hope made some strong points about Lean not being simple cost cutting and how you need “respect for people” as a core element of Lean healthcare, which includes not using Lean to drive layoffs.

One snippet from the article:

Admitting You Have a Problem Is the First Step

Being able to see waste is a first step, but there are also cultural challenges when leaders want to admit that they have waste or problems. It is natural for people to want to hide waste if they fear blame or punishment.

There is a classic story from Toyota's entry into North America, when a local factory leader was asked by visiting Japanese senior leaders what were the top three problems under his supervision. After hearing “no problems,” a response that's often a gut reflex in many organizations, the Japanese reminded him, “‘no problems' is a problem.” As Berwick, a supporter of Lean methodology for health care, says, “We need a culture in which staff members know that they can report on the waste they see and call it by name, without breaking the rules.”

There's some discussion on the H&HN site that you can join in on, or feel free to post a comment here.

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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. […] Did you noticed that they INCREASED staffing levels? Everybody who complains about Lean being just about driving layoffs doesn’t consider that Lean is really about finding the RIGHT staffing levels. It’s like Goldilocks — not too many people and not too few. There are many cases where Lean results in productivity improvement, but Lean organizations find better ways of utilizing and developing people in lieu of just laying them off. […]


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