I attended the Becker’s Hospital Review 8th Annual Meeting in April.  It was apparent that many organizations are using the tools of Lean Healthcare, including value stream mapping, huddles, rapid improvement events, and A3’s, to tackle the myriad of challenges facing healthcare today.  Two of the biggest concerns voiced at the conference were:

  1. How do we measure the ROI of our improvement program?
  2. How do we sustain the improvements?

As a Lean Healthcare coach for the last decade, it was obvious to me that many healthcare organizations have not moved beyond a cursory knowledge and understanding of Lean Healthcare.

A broad definition of a management system is the framework of policies, processes and procedures used by an organization to ensure that it can fulfill all the tasks required to achieve its objectives.  Some would define this as an organization’s rules and regulations.  It is essentially how employees accomplish theirs tasks and duties.

From the context of Lean Healthcare, we refer to a Lean Management System, or LMS.  A typical Lean Management System helps drive continuous improvement and drives an organization toward a common set of goals and objectives.  The tools to help achieve the LMS include foundational Lean Healthcare concepts such as standard work, visual controls and daily management.

Why is there such a stark contract between LMS and what most organizations employ?  Let’s think about characteristics of a “typical” healthcare organization:

  • Firefighting
  • Everyone is too busy for continuous improvement
  • Work-arounds are typical
  • Delays and errors are expected
  • Trouble sustaining improvements
  • Always moving on to the next “flavor-of-the-day”

Healthcare organizations seem to be increasing in their maturity around implementation of Lean principles.  Many are moving away from a tools-heavy approach and have hired staff to help lead the organization through continuous improvement.  However, few have made the shift to a true Lean Management System.

As organizations move beyond the foundational process tools, leaders must guide the organization through the maturity continuum from firefighting, to improvement and standard processes, to sustaining with management systems, and ultimately to aligning all of these to meet the strategic goals of the organization.  For leaders, it is a never ending of journey of improvement and developing the people in the organization to continue that journey.


Tom Stoffel, Vice President for Lean Healthcare and Process Improvement Consulting at HPPToday’s blog was written by Tom Stoffel, principal with Healthcare Performance Partners.

Tom leads healthcare organizations through transformation into self-sustaining Lean enterprises. In addition to hospitals and hospital systems, Tom also leads transformation of subsidiary and independent clinics, physician practices and other outpatient organizations through Lean transformation.

Prior to joining HPP, Tom owned a Lean consulting and training firm which developed healthcare associates through hands-on learning techniques. Tom is an ASQ-Certified Quality Engineer and holds an Engineering Degree from the University of Michigan.

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