See How a British Psychiatrist is Using LEGO Videos to Explain Lean Healthcare


Screen Shot 2015-07-19 at 8.35.26 AMA collection of creative videos was recently brought to my attention and I'd like to share them here. They are created by Dr. Mark Harrison (@leanpsychiatry), a psychiatrist for an NHS Trust. He created the videos by taking photos of LEGO creations and adding voiceover. It's amazing that we all have the technology required to do this, between basic laptops and phones. It's great to see the creativity that results.

Lean Basics

Here is an introductory video created to describe their “SMART Recovery” process and how Lean concepts and terms fit into that approach. Dr. Harrison illustrates a few common workplace scenarios and how waste or problems interfere with patient care.

“Overall, we all come out of the deal pretty well. That's Lean.” How would things be better if you made changes every single day? Great question from Dr. Harrison!


I was thrilled to see him address core Lean concepts of quality, including jidoka (quality at the source), the andon process, and mistake proofing. Jidoka is one of the two core pillars of the Toyota Production System (as Dr. Harrison correctly points out). Yet far too many people miss that and say, erroneously, that Lean is only about speed or efficiency.

Building in quality is better than trying to inspect quality in at the end.This was a core lesson that W. Edwards Deming taught Toyota and others, of course.”

Healthcare tends to follow this approach” (of inspecting in quality at the end), when it's too late to be able to understand the root cause of the problem so we can fix the process and prevent future problems.


Jidoka is one pillar, “just in time” or improving flow is the second pillar of TPS, as this video explains:

Improving flow is key. We work to reduce batch sizes in different ways. That doesn't always mean ONE-piece flow, but Lean presses us to improve flow as much as we can, eliminating barriers to flow over time.

Dr. Harrison uses the example of not batching up the writing of patient notes… instead seeing one patient, writing up the notes, then seeing another patient and writing up their notes, etc. “Batching up all of your note writing takes about a third longer to write” because “the patients blur together” and that “can be a source of errors.”


This video talks about the types of waste that describe and work to reduce through Lean.

Dr. Harrison says that “Lean is not just about big projects,” which is completely correct. We can also address small problems (I'd add that's a core part of the Kaizen approach).  Lean is about getting “everybody to take part” in improvement… working toward “the perfect patient experience.”


This video covers a “very practical” approach that can be helpful in healthcare. As Dr. Harrison points, the goal is improving our effectiveness not just neatness or “tidying up the bedroom.” People shouldn't have to “fight the system just to get things done.”

Starting with the 5S process in one of their treatment rooms, Dr. Harrison and the team found about £3000 of equipment that wasn't needed, so it was sent to other areas that could use them. He says if the organization has perhaps wasted money by buying things that aren't needed, we shouldn't “throw good money after bad” by continuing to pay to store those items.

He's right to point out that “setting standards doesn't turn people into robots,” which is true not just with 5S, but also with standardized work. Dr. Harrison also says, basically, the best way to get started is to get started (something I say about Kaizen). Start with small improvements and just get going to see what happens when you make small changes in the workplace.

Maybe you can use these videos to introduce Lean to people in your organization?

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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.


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