Scientific Method - Without First a Standard There Can Be No Improvement

Lean Healthcare – What is it? Clarity and strong leadership are required to implement lean principles. Another way of saying this is “If you only have a hammer everything looks like a nail”. As commonly thought, Lean is not a way to get the low-hanging fruit in an organization. Rather, lean is a means of developing standard work and operational controls.

Lean Healthcare is a strategic business system, but more importantly a state of mind. This is true because eliminating waste in an organization is a simple concept to understand, but very difficult to implement. Lean is not easy because its principles expose challenges quickly and will lead to organizational friction and reorganization of personnel. Although lean originated in manufacturing companies its principles apply to all aspects of business; most importantly the vigorous involvement of its practitioners. To put it simply – implementing lean is a project that has no end date.

Lean's ultimate goal is to harness the knowledge and energy of an organization's employees - continually. Lean is the transformation of the value delivery process within this organization. Most importantly, the principles of lean expose challenges in real time because it deals with facts and forces problem resolution. The proper roll-out of lean initiatives should exceed patient expectations. Its impact on employees will not only give them the ability to recognize and identify waste, but more importantly give them the courage, confidence, and desire to call it waste. In the end, each employee realizes that failure to act raises costs, produces no corresponding benefit, and may threaten job security as a result.

Lean principals allow areas of specialization also referred to as departmental silos to become seamless and focused on patient transparency. This synthesis is “Value Stream” creation in a hospital setting.

Because lean is difficult to implement it is very important to focus on the fundamentals by solving any problem from the inside out and setting a foundation for continuous improvement. Here are the twelve operating principles of Lean:

1. Standard Work Methods
2. One Piece Flow (Patient Focused)
3. Continuous Flow (Pace)
4. Balanced workload across functional areas
5. Standard work in process
6. Visual Management Control (Transparency)
7. Multi-process capability (Multi-tasking)
8. First in-First Out Flow of Materials
9. Pull System (Supply based on Demand)
10. Rapid Change (Flexibility, Scalability)
11. Error Handling (Logical Backward Flow)
12. Right-Sized Equipment (Space Optimization)

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