TL;DR: The eight wastes give you a lens for seeing problems — but Lean isn't a scavenger hunt for waste. The real work is understanding why waste exists and building systems where people feel safe enough to point it out.
My friend and mentor Pascal Dennis, who worked at Toyota in Canada and has been a deeply thoughtful teacher of Lean principles, once said something that has stuck with me:
Lean is not a “scavenger hunt for waste.”
He's right. If all we do is walk around labeling things as waste, we haven't actually improved anything. Lean is fundamentally about creating value for customers and patients — and eliminating waste is in service of that goal, not the goal itself.
That said, having eyes for waste is genuinely helpful. Being able to recognize waste in its different forms is one of the most important inputs into Lean improvement and problem-solving methods. It's the starting point for asking better questions:
- Why does this waste exist?
- What in the system allows it?
- What would need to change?
These are all no-blaming questions. We're examining the system, not finding fault in the people who work in said system.
And here's something that often gets overlooked: people have to feel enough psychological safety to point out waste. If someone identifies waste in a process and their manager reacts dismissively with, “Are you saying we've been doing it wrong this whole time?” — that person will probably not speak up again. Seeing waste is a skill. Being willing to name it out loud is a function of culture.
Or, if people speak up about waste and they're told, “That's not really a problem,” or nothing happens, they'll stop speaking up out of futility.
So let's walk through all eight types of waste, with examples drawn primarily from healthcare — because that's where I've spent most the last 20 years of my career. These examples come from my book Lean Hospitals and from many years of consulting with health systems. But the concepts apply in any industry.
Check out this video, as well:
Where the Eight Wastes Come From
Taiichi Ohno, the architect of the Toyota Production System, originally defined seven types of waste (muda, in Japanese). Later publications (by others, including Norman Bodek) added an eighth: the waste of human potential, sometimes called the waste of talent or the waste of underutilized people.
Toyota didn't intend this list to be rigid or all-inclusive. It's a framework — a way to train your eyes to see problems that are otherwise invisible because they've become part of “the way we've always done it.” Consistent terminology helps us communicate within our organizations and across industries, but the exact labels matter less than the thinking they enable.
The eight types are: defects, overproduction, transportation, waiting, inventory, motion, overprocessing, and talent. Some people use the acronym DOWNTIME or TIM WOODS as a memory aid. Use whatever works for you. The important thing is developing the habit of recognizing waste in your own work — and then doing something about it.
1. Defects
A defect is any work activity that isn't done right the first time. In a healthcare setting, defects range from a form filled out incorrectly to a medication error that causes patient harm.
The Institute of Medicine estimated that 400,000 preventable drug-related injuries occur in hospitals each year, leading to $3.5 billion in unnecessary costs. Each of these is likely caused by one or more process defects — illegible handwriting, misplaced decimal points, misclicks in an EMR system, or breakdowns in the process for getting medications to the right patient.
A defect doesn't have to cause harm to count as waste. A “near miss” or “good catch” still represents waste — the error occurred, time was spent catching and correcting it, and the risk existed even if the outcome was acceptable.
In one hospital's anatomic pathology lab, slides were sometimes unfindable after being read, requiring tissue blocks to be recut. The rework, delay, and cost were all waste caused by a process defect in how slides were organized and stored.
One thing worth noting: inspection is often called “non-value-added” activity. But, as my friend Jamie Flinchbaugh has pointed out, inspection may be necessary until you've eliminated the causes of defects. Just eliminating inspection steps before your process is capable of producing zero defects will cause more problems and more waste if defects get to your customers.
I've visited Toyota plants in Japan, Kentucky, and San Antonio, and every one of them has a large, well-staffed (and well lit!) final inspection area. Rather than following dogma, they're being practical: they haven't yet achieved perfect quality, so final inspection prevents defects from reaching the customer. As much as they aim to mistake-proof processes and build in quality… they still have inspection.
The goal is to make inspection unnecessary by building quality into the process — but you can't just eliminate the inspection step and hope for the best.
2. Overproduction
Overproduction means doing more than what is needed by the customer, or doing it sooner than needed. In manufacturing, overproduction often shows up as excess inventory sitting on a shelf. In healthcare, it takes different forms.
Studies show that 20 to 50 percent of hospital lab tests may be completely unnecessary — ordered by residents or physicians out of habit, defensive medicine, or a lack of current clinical guidelines. Unnecessary tests don't just produce information that isn't medically useful — they can cause patients to become anemic from excessive blood draws.
The University of Utah Health Care started requiring residents to justify each test and saved $200,000 a year. I hope that approach came across more as coaching and learning focused than being punative.
Hospital pharmacies face a related problem. Delivering medications too early (before orders are confirmed or before the patient needs them) leads to returned medications. At Riverside Medical Center, 480 medications were returned to the pharmacy each day, and employees spent 11 hours daily processing those returns.
Virginia Mason Medical Center tackled overproduction of diagnostic procedures by referring certain patients to physical therapy before approving radiology procedures. The less expensive therapy was often more beneficial for the patient. Unfortunately, this responsible reduction in waste initially hurt their revenue because the payer system rewarded the more expensive procedure — a systemic problem that Virginia Mason addressed by proposing a savings-sharing arrangement with insurers.
At its core, the waste of overproduction reminds us to ask: Is this step truly needed for the patient right now? That question can be uncomfortable, but it's essential.
3. Transportation
Transportation waste refers to excess movement of the product through a system. In healthcare, the “product” is often the patient, a specimen, a medication, or a piece of information.
One hospital using Lean methods to improve surgical patient flow discovered that a 74-year-old woman walked the equivalent of five and a half football fields during the course of her visit for a procedure. That's transportation waste experienced directly by the patient.
Park Nicollet Health Services in Minnesota built its Frauenshuh Cancer Center specifically to reduce patient transportation. Rather than making sick patients walk between buildings and areas, the center was designed so patients remain in a single room for nurse and doctor visits, lab draws, treatment, and other support services. “Where care comes to you” became both a design principle and a marketing message — and a clear example of patient-centered care. Virginia Mason's Floyd & Delores Jones Cancer Institute followed a similar model, saving patients 500 feet of walking and hours of time.
Transportation waste often interacts with other types of waste. In many hospitals, blood specimens are collected in patient rooms but then carried in a tray from room to room as the phlebotomist collects more specimens. The phlebotomist's motion is reduced, but the specimen's transportation time and the patient's waiting time both increase. These trade-offs are worth examining rather than accepting.
4. Waiting
Waiting is time when nothing value-added is happening. It's the type of waste most visible to patients and most frustrating to employees.
Patients wait for appointments, wait in waiting rooms, wait for results, wait for discharge. Wait, wait, wait. We've all experienced that.
Every handoff between departments (or steps in a process) is a potential waiting point. But employees wait too — for patients, for information, for equipment, for a computer to become available, for a response from another department.
I won't belabor the point because most people in healthcare don't need to be convinced that waiting is a problem. They just might think “well, there's nothing we can do about it.”
What's worth emphasizing is that the root causes of waiting are usually found somewhere else in the system — not in the department where the waiting occurs. Emergency department wait times, for example, are frequently driven by delays in the inpatient discharge process, not by anything happening in the ED itself.
Hospitals can look for ways to replace idle waiting time with productive activities, including problem solving and continuous improvement work, rather than simply sending people home when things are slow. The book Healthcare Kaizen explores this in more detail.
How Dr. Sami Bahri Eliminated the Need for a Dental Waiting Room.
In outpatient settings, one survey showed that excessive waiting room time was the primary complaint of 72% of U.S. dental patients. Sami Bahri, DDS — sometimes called “the world's first Lean dentist” — took that seriously.
At the Bahri Dental Group in Jacksonville, Florida, he used Lean methods to eliminate waiting room time for patients while actually increasing patient volumes. Traditionally, patients needing care beyond a basic cleaning would be diagnosed and then scheduled for a follow-up appointment.
Bahri rethought the flow so most patients could be treated in a single visit if they wished. The total time required for a complex patient's complete treatment fell from 99 days in 2005 to 10 days in 2008. And he treated the same number of patients in 2006 as the year before with 40% fewer resources — reducing staff through attrition, not layoffs.
That's worth emphasizing: reducing waste in the system meant better results for patients and the practice without anyone losing their job.
5. Inventory
All inventory — materials, supplies, equipment, medications — is not inherently wasteful. Some amount of inventory is necessary for daily use, or occasional use. Excessive inventory is the waste. We have more than we need to provide the right care at the right time.
It would be a mistake for a hospital to say something like, “Lean says all inventory is bad.”
When inventory is too high, cash is tied up on shelves, storage space is consumed, and items expire. One hospital used Lean to reduce medication stockouts by 85% while simultaneously reducing total inventory on hand. That's the right outcome: better availability with less waste.
But here's where judgment matters. Many manufacturing companies harmed themselves by thinking Lean meant keeping inventory as low as possible, period. Running out of inventory in a hospital can result in preventable harm.
A nurse who can't find the right supplies might use a less-effective substitution, or skip a safety step because the proper equipment is too far away to retrieve.
In one hospital unit, lift assists were stored in a closet on a different floor. Because it was so inconvenient, nurses often lifted patients without the assists — increasing the risk of both employee injuries and patient falls. The real improvement was using the 5S process to free space and relocate the lifts to the unit.
Improved inventory management also supports other improvements. One hospital working to reduce central line infections found that a technician or nurse had to gather ten separate items from various locations before the procedure. If one item was forgotten — say, a drape — there was temptation not to walk back and get it. Assembling all items into a single kit reduced both the inventory problem and the infection risk.
6. Motion
Motion waste refers to unnecessary movement by employees. In healthcare, walking is the most common form.
Studies have shown that nurses in some hospitals walk six miles or more per shift, much of it searching for supplies, medications, equipment, or information. One lab I worked with discovered that employees were walking excessive distances due to poor department layout. An orthopedic surgeon realized nurses were making dozens of trips per case because instruments and supplies were stored in three different locations.
An example of a spaghetti diagram, from Lean Hospitals:
Even at a workstation, unnecessary motion adds up. Excessive clicking through EMR screens, reaching into poorly organized drawers, or bending repeatedly for supplies stored at floor level are all motion waste. The pharmacy technician who rearranges her workbench so frequently used items are within arm's reach instead of buried in ankle-height drawers — that's eliminating motion waste. Small change, real impact.
As with inventory, the solution isn't to just tell people to walk less. Hospitals need to improve the system. When nurses hoard supplies in their pockets because the supply room is too far away, that's a workaround driven by a layout problem. Blaming the nurse misses the point entirely.
7. Overprocessing
Overprocessing means doing work to a higher level of quality than required or doing work that serves no purpose. It's sometimes the hardest waste to see because it looks like “being thorough.”
In one hospital, an employee spent three hours a day folding towels after they came back from the laundry. Nurses upstairs were immediately unfolding them and laying them flat. The folding step was pure overprocessing — activity that consumed time but created zero value.
In a home health billing department, one employee removed duplicate paperwork from patient charts, only to have the next employee in the process walk right past her to make new copies of those same forms. Neither employee understood how her work fit into the overall process. When a Lean coach asked them to stop and explain their work to each other, they immediately realized the waste and changed the process.
Labs sometimes spin blood samples in centrifuges longer than necessary — either from habit or from settings that were never updated. Beyond the point of separation, additional centrifugation adds no value. It's just overprocessing that delays results.
Excessive EMR alerts are another form. When physicians and nurses are bombarded with warnings they routinely click through, the system is overprocessing — generating alerts that nobody reads, creating fatigue that actually increases the risk of missing the one that matters.
8. Waste of Talent (Human Potential)
The eighth type of waste is not always included in Lean literature. Some sources list only Ohno's original seven, arguing that the waste of human potential is embedded in the others. Those who do list it separately — and I'm among them — emphasize the importance of people in the system.
If highly skilled employees spend their time searching for supplies, clicking through unnecessary EMR screens, or processing returned medications, we are not getting the most out of their potential. One form of this waste is healthcare professionals not working to their level of licensure — nurses doing work that could be done by nursing assistants, pharmacists doing work that pharmacy techs could handle effectively.
But the deeper form of this waste is what happens when we don't ask people what they think.
At the start of one consulting engagement, a laboratory technologist with more than 25 years of experience told me,
“Nowadays, I feel like a robot.”
Managers rarely asked employees for their opinions or ideas about improving the department. The creative, problem-solving capacity of an experienced professional was sitting idle — not because the person lacked ideas, but because the system never invited them.
Lean is a countermeasure to feeling like a robot.
At one hospital, a nurse commented that their initial Lean work led to
“the first time in six years that anybody has asked me what I think about anything.”
That's an incalculable waste. And it connects directly to psychological safety. People fall into a cycle where they feel unheard, so they stop trying. As I wrote in my book The Mistakes That Make Us, research by Ethan Burris from the University of Texas identifies two primary reasons employees don't use their voice: fear and futility. Fear of punishment for speaking up. Futility because speaking up doesn't lead to action.
When we eliminate the waste of talent, we're not just making processes more efficient. We're restoring something fundamentally human — the ability to contribute, to improve, to feel that your knowledge and experience matter. That's respect for people in action.
Seeing Waste Is the Beginning, Not the End
Learning to see waste is a skill that develops over time. Once you learn to see it, you can't unsee it — which, as Karen Martin has said, is both a gift and a career hazard.
But identifying waste is the starting point, not the destination. As Jamie Flinchbaugh put it in a conversation we had:
“You see the type of waste, and then you go, what's the cause of that waste? And then you eliminate the cause. You don't just take out the waste.”
You can't eliminate inventory waste without first improving the systems that make you hold excess inventory. You can't eliminate inspection without first eliminating the causes of defects. The waste is a lens. The underlying problems are what you actually solve.
And remember — the categories are a communication tool, not a scoring system. Whether you classify unnecessary radiology procedures as overproduction or overprocessing doesn't matter nearly as much as whether you actually improve the process. I've seen teams spend more time debating which waste category a problem belongs to than working on the problem itself. Don't do that.
What matters is this: Can you see the waste? Can you name it? Can you help your team feel safe enough to point it out? And then — can you do something about it?
That's the work.
Related Posts:
- What Is Kaizen? Meaning, Principles, and Examples
- Lean Daily Management: What It Is and How to Get Started
- Psychological Safety as a Pre-Condition for Lean
- Boeing and the Consequences of Schedule Over Safety
Books Referenced:
- Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement (3rd Edition) by Mark Graban
- Healthcare Kaizen by Mark Graban and Joe Swartz
- The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation by Mark Graban
The eight wastes are defects, overproduction, transportation, waiting, inventory, motion, overprocessing, and the waste of talent (also called the waste of human potential). The first seven were originally defined by Taiichi Ohno of Toyota. The eighth was added later to emphasize the importance of engaging people's creativity and knowledge in improvement.
Taiichi Ohno's original framework included seven types of waste. The eighth — the waste of talent or human potential — was added by later Lean practitioners to highlight the cost of not engaging employees in problem solving and improvement. Some organizations still use the original seven, while most now include the eighth.
The eighth waste is the waste of talent, also called the waste of human potential or underutilized people. It refers to the loss that occurs when organizations don't engage employees' knowledge, creativity, and ideas. Examples include highly skilled professionals spending time on tasks below their capabilities, and employees whose improvement ideas are never sought or acted upon.
The eight wastes appear throughout healthcare in forms including medication errors (defects), unnecessary diagnostic tests (overproduction), patients walking excessive distances (transportation), long wait times for appointments or results (waiting), expired supplies (inventory), nurses walking miles per shift to find equipment (motion), redundant data entry (overprocessing), and experienced clinicians whose improvement ideas are never solicited (talent).
Common memory aids include the acronyms DOWNTIME (Defects, Overproduction, Waiting, Non-utilized talent, Transportation, Inventory, Motion, Extra-processing) and TIM WOODS (Transportation, Inventory, Motion, Waiting, Overproduction, Overprocessing, Defects, Skills). Use whichever helps you — the important thing is developing the habit of recognizing waste, not memorizing a specific acronym.
 with real healthcare examples from hospitals and health systems.){kind=link}