The Global Spread of “Lean Hospitals”


I'm in beautiful Traverse City, Michigan for a few days for the Michigan Lean Consortium annual conference. It's my home state, so it's great to see the collaboration around lean healthcare and lean, more generally.

Michigan, along with other industrial states like Wisconsin and Iowa, have been strong adopters of lean healthcare, but the ideas are spreading around the world, as evidenced by some updates and web traffic for my first book Lean Hospitals.

Looking at translations of that first edition, my book has been or is being translated into:

  • Polish
  • Thai
  • Arabic
  • Hungarian
  • Simplified Chinese
  • Complex Chinese
  • Turkish (already available)

I've heard a rumor that the book is being translated, unofficially and somewhat illegally, into Persian/Farsi. The translation is being done in Iran, so, um, what can you do? There are also some talks with a Dutch publisher, so we'll see what happens there.

Looking at the server logs for, recent visitors from outside the U.S. include:

  • Iran (searching Google for “characteristic of the lean hospital”)
  • Australia
  • Ghana
  • South Africa
  • Saudi Arabia
  • Iran (searching for “lean hospitals”)
  • Germany (searching for “lean hospital”)
  • United Kingdom
  • Hungary
  • Iran (different location again, searching for “lean hospital”)
  • Oman
  • Iran (different location again)
  • Russia
  • Malaysia
  • Canada
  • Kenya
  • France
  • South Korea
  • Belgium
  • Ecuador (Searching for “different hospital flows in lean hospitals”)
  • Portugal
  • Spain
  • India (where I might be going in March 2012)
  • Lithuania
  • Sri Lanka
  • Netherlands
  • Taiwain
  • Italy
  • France
  • El Salvador
  • Slovenia

This is all in the past week. Honestly, there is as traffic from outside the U.S. (49.8% of hits) than within (51.2%).

The effort has stalled and failed somewhat, due to some problems with the customizable Google Maps features, but I had been working with others in trying to create a map that showed documents cases of lean healthcare from around the world. Pins and locations keep disappearing from the map after being added, plus it's just really clunky to add locations to a custom map.

It sure is humbling to see the spread of these ideas around the world – for better patient care, more access, and lower costs. Everybody is trying to improve healthcare…


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  1. Vanda Ametlli says

    Keep up the outstanding work Mark!!!

  2. Dean Bliss says

    Congrats, Mark. To me, this illustrates two things. One, the terrific content of the book; and two, the thirst for knowledge on the subject. We all need to keep this subject in front of as many people and audiences as possible. We need to be ready (or as ready as we can be) for healthcare reform.

  3. Mark Graban says

    Thanks, Vanda and Dean.

    I’m thrilled that my book is being bought and translated around the world.

    I’m more excited that the ideas are spreading and that the interest is growing around the world. I’d certainly not want to think I’m taking credit for that, though… (and I know I haven’t been accused that, but just saying…)

  4. Enrique Herrera says


    Few Latin American countries logging. I ´ll do my best to include Costa Rica into the list.

    What about a spanish translation? With the issues we have here in Costa Rica with Social Security and Healthcare, your book will be an eye-opener.

    1. Mark Graban says

      Hi Enrique – to get a Spanish translation, we’d have to find a publisher willing to do the translation and publish it. I’m not sure why we haven’t been approached with an offer as we have with other languages…

      Thanks for reading from Costa Rica! How much lean healthcare work is happening there?

      1. Enrique Herrera says

        Well, sadly very few lean healthcare happening here. We have both public and private healthcare. Public Healthcare is run by a Government office called Caja Costarricense del Seguro Social or CCSS for short. As you might ´ve guessed, this type of healtchare is slow, full of wait times, old infrastructure, and with a union force that is probably the biggest obstacle of them all. I know that an office dedicated to Lean implementations has tried to do some work here, but with no big results. Let me investigate a bit on what the real outcomes were. Let me check on that Spanish translation as well.

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