Throwback Thursday: A Lean Healthcare Conference From 2007

Back in 2007, I had my first opportunity to travel to England, a country I really love visiting. I had the chance to attend the “First Global Lean Healthcare Summit” that was produced by Dan Jones and the Lean Enterprise Academy. They actually have posted many of the slide decks from the Summit there on the site, but there's no video that I can find. I've embedded some of the decks below and I've also added some of my notes that I took.

From the archive page:

“The event sold out with 320 people (over half from hospitals) attending from 147 organizations from the UK, Ireland, Denmark, Norway, Sweden, Netherlands, Belgium, Germany, Italy, Spain, Turkey, Poland, Switzerland, France, USA, Canada, Brazil, India, South Africa, Singapore, Australia and New Zealand.”

I found some of my notes and quotes from the Summit, which I'll share below.

Opening Reflections From Dan Jones

Dan Jones kicked things off. A few thoughts of his:

Lean focuses on managing processes to create value, not on managing individual activities. It is a management system based on the scientific method, where learning happens through experimentation using PDCA. Lean cannot be learned conceptually–it must be practiced. Standardization is not the same as command-and-control; when done well, it supports learning, consistency, and improvement in complex healthcare environments.

Transforming Emergency Care at Flinders Hospital (David Ben-Tovin)

David Ben-Tovin, the CEO of Flinders Hospital from Australia said:

Their emergency department was the worst in the state–by their own admission, “we were killing people.” Four years later, it was clearly the best, even while handling a 50% increase in volume.

Early on, they recognized that they were “really good at blaming each other.” Through Lean, care became both safer and less expensive. They also realized how much poor quality they had come to tolerate–especially when compared to the standards expected at a local box manufacturing company.

Lean, as they described it, was not about tools or projects, but about becoming a learning and problem-solving organization.

Creating Flow and Safety at Bolton Hospital (David Fillingham)

David Fillingham, CEO of Bolton Hospital in England said:

David noted that CEOs tend to be positive and upbeat people–and sometimes overly optimistic about how well things are actually working. Many leaders carried a “fantasy patient journey” in their heads, but the reality was very different, with significant waste throughout the system.

At the time, one in ten patients experienced an event that could cause harm, and 40% of staff reported seeing a harmful error in the previous month.

Through Lean, the organization focused on deliberately designing and managing processes rather than relying on ad hoc workarounds. This included improving the flow of patients, staff, and information; designing physical layouts that supported flow; practicing evidence-based medicine; and developing everyone as a problem solver. In total, 525 staff participated in 85 Rapid Improvement (Kaizen) Events.

The guiding belief was simple: “Good quality costs less.”

Results included a 30% increase in cataract capacity, a 36% reduction in trauma mortality, and a 33% reduction in length of stay. As the CEO put it, “We're part factory, part hotel”–requiring both reliable processes and good patient experiences.

They also drew on David Mann‘s Creating a Lean Culture in their pathology work. The underlying conclusion was stark but clear: “We are failing our patients, staff, and funders–not because of bad people, but because of bad processes.” 

What Toyota Teaches Us About Lean Leadership (John Shook)

John Shook presented (via video, if I remember, because he had a flight problem)… it was my first time hearing him, so I learned a ton:

In a Toyota Production System context, the manager's job is to help each person take initiative and solve problems to improve their own work, while ensuring that every role is aligned to creating value for the customer and long-term prosperity for the organization. As the speaker emphasized, “Getting people to think and take initiative is the key.”

People should feel “comforted and supported by the system,” not pressured or controlled by it. One guiding idea shared from Toyota leadership was to “lead the organization as if you have no power”–advice Ken Higashi gave to Gary Convis as he was learning to lead at Toyota and NUMMI.

At Toyota, responsibility is not the same as authority. Leadership is neither strictly top-down nor bottom-up. Instead, processes are well-defined and responsibilities are clear, allowing the organization to move away from debates about authority or territory and toward dialogue about doing the right thing.

Telling people exactly what to do removes their sense of responsibility–if the solution fails, it becomes the leader's failure rather than a learning opportunity for the team. Leaders may expect results, but results come from the process.

Ultimately, the manager's role is to develop people. Problem solving follows a simple pattern: go see the work, ask why, and show respect for everyone in the system–both customers and employees. Lean, at its core, is about making mistakes and learning from them.

Lean Leadership Starts With Purpose (Jim Womack)

Jim Womack also presented:

With Lean, the starting point is always purpose–what's the point of the work? The goal is to provide value to the customer in a way that allows the organization to prosper over the long term.

That leads naturally to questions about process: Who is responsible for the process? Who clarifies its purpose? And who is responsible for driving improvement?

The answer is not the improvement department alone. Improvement should be driven by everybody, every day.

When Lean efforts struggle, the issue is rarely a lack of tools. More often, it's a lack of leadership–or the right kind of leadership. Problems arise when Lean tools are applied without Lean thinking.

In problem solving, leaders should always ask, “Is that really the problem?” and be open to alternative explanations and solutions.

If problems aren't being addressed, people will do what they've been told only when leaders are watching–hardly the foundation of a sustainable improvement culture.

When Healthcare Errors Become Personal (Peter Willats)

Peter Willats, a partner with McKinsey, has experience primarily in the auto industry. He shared a very personal story about his 2-year-old son who was battling cancer and all of the mistakes the hospital made during his treatment, and his frustration in not being able to get answers about WHY these things occurred and how they could have been prevented.

His son got a central line infection in the hospital. Willats had “personally observed 4 different standards and 14 applications of the “standard” method.”

He said we “need to change the mindset that medical error is inevitable.” His son had donated two bags of stem cells to be used after some treatment. After treatment, one of the two bags were broken during thawing.

Willats responded the way an automaker would, sending the hospital (as a supplier) a letter that asked them to answer process-related questions, such as:

• Had this problem occurred before?
• Were the thawing process and procedures documented? If so, where were the procedures stored?
• Had the people working that day been properly trained? If so, where were the training records?
• Who was the vendor of the bag? What was the lot # of the bag? Had the bag been saved for investigative purposes?

He requested a response within seven days and never heard anything back.

Building a Lean Culture at ThedaCare (John Toussaint)

Dr. John Toussaint spoke and it was the first time I met him. I embarrassed myself by saying something about ThedaCare being in Minnesota instead of Wisconsin. Ooops. I'm sure John doesn't remember that.

Lean requires courage–the courage to ask, “Why do we do it that way?” At baseline, nurses were losing an average of 3.5 hours of wasted time in an eight-hour shift. Through 5S and process improvement, that was reduced to about one hour.

They also found that employee engagement deepened over time. Staff who participated in two or more Rapid Improvement Events showed statistically significant increases in employee satisfaction–participation in a single event was not enough.

To support this work, the organization redeployed approximately 3% of its workforce into full-time improvement roles, reinforcing that continuous improvement was not optional or episodic, but a core part of how the organization operated.

 Final Reflections and Challenges for Lean Healthcare

Jim Womack wrapped things up by saying:

Jim cautioned that, “If this Lean stuff seems easy, you're probably not doing it.” Isolated or point kaizens can be helpful, but they are not sufficient on their own.

Sustained improvement requires “small batch metrics”–frequent, timely measures that allow leaders and teams to see problems quickly, rather than relying on monthly averages that obscure variation and delay learning.

He underscored the moral dimension of the work, noting that while defective cars rarely kill people anymore, preventable harm in healthcare remains far too common. Fixing this, he said, is a moral obligation.

When Lean is practiced deeply and consistently, the work is challenging. As the Toyota saying goes: “Every day is hard, but life is good.”

Why This Still Matters in 2026

Nearly two decades have passed since that first Global Lean Healthcare Summit in 2007. The tools have evolved, the language has shifted, and technology has changed dramatically–but the core challenges discussed at that conference remain strikingly familiar in 2026.

Healthcare systems around the world are still grappling with preventable harm, staff burnout, access challenges, and rising costs. Many organizations still struggle with the same issues highlighted back then: overly optimistic leadership views, fragmented processes, blame-oriented cultures, and improvement efforts that rely too heavily on tools instead of thinking.

What makes these reflections enduring isn't nostalgia–it's relevance.

The speakers in 2007 weren't talking about Lean as a set of techniques. They were talking about leadership, purpose, systems, and learning. They emphasized that improvement depends on psychological safety, on leaders who are willing to “go see,” ask why, and admit when the system isn't working as intended. They challenged the idea that healthcare harm is inevitable and framed improvement as both a leadership responsibility and a moral obligation.

Those messages matter even more today.

In 2026, many healthcare organizations are experimenting with new technologies, analytics, and AI-enabled tools. But without the foundations discussed at this conference–clear purpose, well-designed processes, engaged frontline staff, and leaders who develop people rather than direct them–those tools risk becoming just another layer of complexity.

What this conference reminds us is that Lean is not something you “install” or complete. It's something you practice, struggle with, and recommit to over time. As Jim Womack said back then, if Lean feels easy, you're probably not doing it. And as the Toyota saying goes, when it's done seriously, every day is hard–but life is good.

That's why this still matters. Not because 2007 had all the answers–but because the questions they were asking are the same ones healthcare leaders still need the courage to ask today.