Lean in Health Care, a Collaborative Effort

There is a lot of excitement today in the health care field about the benefits that Lean practices can bring. This is especially critical in an environment where patient care and needs are climbing while the pool of skilled resources and reimbursement for services shrink. Lean Advisors Inc. is working in the Health care industry to help implement Lean. The key is to apply Lean methods in an environment driven by the unique values that surround patient care. Your patient, should come first. The patient drives the definition of value. Your work environment is one driven by shared values and passion in delivering top quality care and services to the patient.

Lean Health Care Principles

The Lean principles of patient focus, speed of delivery, increased quality, and flexibility in meeting ever-changing demands aligns well with your environment. Hospital professionals are surprised to see similarities with other industries when they sit down and look at the benefits of applying Lean methods. Once you have the ‘right’ Lean knowledge, and know how to apply the tools properly, you are able to see that Lean implementation is beneficial in meeting the needs of patients in coming years.

What Is Lean?

Lean or “Lean thinking” was a term first coined by students studying Toyota at MIT. Authors Womack and Jones subsequently used this term in a book they published in the 90s titled Lean Thinking. At the core of the Toyota philosophy is a focus to continually identify and root out wasteful activities. Lean tries to minimize variation within the workplace and to better balance the work between processing steps. Waste can be defined as any activities within a process that does not add value to the procedure, service or care provided.

Lean has been used extensively in various manufacturing and service industries to increase efficiency and customer focus through the elimination of waste. In recent years, this process-based solution has also been applied in numerous Health care settings.

Types of waste


  • Over production – doing work faster or sooner than the next process requires it
  • Inventory – work waiting for next process step; patients in waiting rooms
  • Waiting – staff or patients waiting
  • Transportation – unnecessary transportation of patients, supplies or walking to your next task
  • Motion – not having the supplies or equipment required to complete your task
  • Over processing – doing more than is necessary. Adding extra steps to the task
  • Quality defects – any type of error or rework that consumes time or delays the next step
  • People’s skills – not fully utilizing staff and/or using their knowledge and experience to make the end-to-end processes flow better
  • Re-prioritization – changing work demands, firefighting

Our Experience with Lean in Health Care

Health care workers are used to change. Your profession and environment is constantly adapting to new technologies, processes, regulations, and tools – you have learned to expect rapid change. Participants are more than willing to listen and learn about something new that could make patient care even better in a world of shrinking resources. Our task is to help you look at your work differently from a Lean perspective. Without this new perspective, we tend to reinvent or rationalize the current practices.

Our goal is to help everyone understand the end-to-end value stream from the patients view. Once we have the ‘current state’ we need to develop a vision or ‘future state’ on how we would like things to be. From here, we develop and document a plan to create the future state. Our challenge is to keep everyone on plan and focused. All too often, we get caught up in isolated projects or projects completed in the wrong sequence. This creates ‘exciting chaos’, all too easy under the pressures of day-to-day emergencies and the desire to just do something. ‘Exciting Chaos’ happens when you fail to improve the entire end-to-end system.

Key ideas:

• Reduce waste – Ensures activities being done are of value in order to optimize our available resources and in particular our staff. This can also help reduce wait times.
• Improve patient flow – Organize all of our processing steps from check in to discharge from a patient perspective. This ensures everything is done just in time reducing delays, “wait times” and frustration for everyone. It also minimizes the chance for mix-ups and other errors.
• Standardize process – By reducing variation, one reduces the chance of mistakes and people are more aware of the level of expectation. It is also easier for someone to step-in when necessary if workstations and processes are standardised.
• Set realistic expectation – Awareness increases when we establish realistic expectations. These expectations are based upon what the end-to-end processes should deliver rather than measuring people.
• Use visual cues – Allows communication quickly and effectively in a non-verbal way. These can also quickly highlight any problems allowing them to be fixed rapidly rather than developing.

Lean Health care Results

Lean doesn’t focus on cutting people or assets; it focuses on improving activities and processes in the system as a whole. In order for any business or organization to get better, they must learn how to remove the waste in their system and create value and meet the demands of their customers, your community.

When done properly, Lean allows the professionals and staff of hospitals, labs, and clinics to focus on more patient value-based activities. Non-value added activities are replaced with value added work. The result is being able to do more while increasing our job satisfaction – more people can be assisted with the same number of people, with the same (or less) space, while reducing costs and providing improved service