Improving Healthcare
through the Application of Lean
Philosophies, Principles and Tools
Gene Flenke
More and more healthcare organizations around the
world are embracing the Lean Philosophies, Principles
and Tools to improve quality, reduce average length
of stay, reduce cost and improve patient experience.
is usiness mana ement tec ni ue first e an
to emerge with Henry Ford’s moving automobile
assembly line. They were further developed and
refine ta t r anu acturin a ter s me
of their executives made a benchmarking visit to the
U.S. after World War II and brought back what they
learned to their factories. This became known as The
Toyota Production System or “Lean”. Today we see
t e results t se e rts ver man ears it
producing automobiles that are consistently at the top
of consumer reports for quality, safety, reliability and
cost of ownership.
So what is Lean all about, and why is it being adopted
man i erent in ustries all ver t e rl
Lean aims to simply understand the Voice of the
Customer (VoC), what they value and being relentless
in t e s stematic i entificati n an eliminati n
aste s t at value rk can r m ve
continuously from start to completion. Lean is the most
e cient a t pr vi e t e i est ualit pr uct r
service and reduce process variability which also makes
the work easier.
Lean is based on two tenants: 1. Respect for
employees through challenging work. 2. Continuous
Improvement (relentless elimination of waste). These
wastes are universal for any industry and are typically
categorized as follows: 1. Defects (unacceptable
outcomes) 2. Overproduction (completing work ahead
of when the next process can accept it) 3. Waiting
(people or equipment waiting for work to process)
4. Non-respectful Behaviors (not treating each other
respectfully or in alignment with Hartford Healthcare’s
10 Leadership Behaviors) 5. Transportation (moving
patients, supplies and equipment around to complete
- 18 -
work) 6. Inventory (excess supplies, materials or patients
waiting to be cared for) 7. Motion (excess movement
of people in completing their work tasks) 8. Excess
processing (doing more work than planned to complete
tasks within a process to acceptable standards/
protocols). These wastes are critical to identify and
eliminate because they add time, cost and negatively
a ect ualit
Hartford HealthCare (HHC) is in the midst of a multi-
year plan to implement Lean across all aspects of its
business. HHC is already seeing some great results such
ta as reductions in readmissions, reduced length of stay,
shorter ED door to doctor time, trimming inventories
and improved access to primary care appointments.
Implementing Lean in any industry is not
easy nor for the faint of heart. It requires
leadership commitment at all levels,
Lean experts to guide the way, and the
engagement of the entire workforce in
improving how they work.
Given the speed at which healthcare is changing - the
rise in healthcare costs, deductibles, payer mix changes,
and more knowledgeable consumers - a successful
Lean transformation will require everyone who touches
a patient or provides direct or indirect support for
patients t e pen t t inkin i erentl a ut l n
held beliefs. Those involved must also be willing to
form a partnership whose primary focus is on what is
best for the patient/customer.
Those healthcare organizations that have the courage
and tenacity to stay the course will enjoy results and
outcomes beyond what they could have imagined -
results such as industry best Patient Experience Scores,
Quality, Cost, Census and Surgical Volumes. g
TH E O P E N JO URNAL • FALL 017