I recently was part of a ‘move in’ effort at a brand new healthcare facility…at about the same point in time, I began to read to the new book Lean-Led Hospital Design, Creating the Efficient Hospital of the Future, written and published this year by my friends Naida Grunden and Charles Hagood. What a unique coincidence for me, reading a first class discussion about the application of Lean Healthcare concepts and tools to new healthcare buildings while intensively working to get an existing healthcare organization up and going in their brand new, sparkling facility!

From the beginning, Naida and Charles point out some unique ideas about the why and how of Lean Healthcare construction, including some ‘basics’ that everybody who is thinking about construction should take to heart! Three beginning points to contemplate:

  1. The Building is Not an Excuse! Dysfunctional buildings never qualify as a legitimate excuse to not strive for continuous process improvement within the existing walls. Grunden and Hagood point out that while fairly recent healthcare quality outcomes for Cuba and the U.S. are very similar, the U.S. has the most expensive healthcare system in the world while Cuba’s has one of the lowest! Healthcare facilities in Cuba are nowhere near as good as what we have here but those buildings don’t seem to serve as excuses for their efforts for perfection.
  2. Build Only If It Creates Value! Grunden and Hagood suggest that an appropriate time to build is when you note diminishing returns from existing process improvement activities. When your process improvement teams note the existence of more and more facility ‘monuments’, you’re probably ready to begin the ‘design and build process’!
  3. If You Build or Remodel, Be Prepared to Invest Up Front! Investing in the involvement of those that perform the ‘regular’, everyday work in the design effort costs time and money. However, their participation typically results in better outcomes and  greater ‘buy in’  of the final design. Grunden and Hagood also suggest that a Lean–Led design effort means taking the ‘long view’ when we consider investment in buildings. This requires us to consider not only the initial costs but also the on-going or recurring operating expenses. If our new design allows us to minimize waste, we should clearly see those benefits in our continuing cost structure!

Good luck on your building or remodeling effort! Lean-Led design, combined with Lean Healthcare principles, certainly makes sense to me!


This week’s blog was written by HPP consultant and engineer David Krebs.

David, a Six Sigma certified engineer, oversees various HPP projects and Lean Healthcare transformations for clients throughout the USA. David is also a Licensed Professional Engineer in the state of Tennessee, with over 30 years of experience in a variety of process and systems intensive industries, as part of firms in the U.S, Germany, and France.  David has achieved and maintained QS-9000 and ISO-14001 certification & received Nissans’ “Quality Master Award” on three occasions.  He holds a Bachelor of Science degree in Mechanical Engineering from the University of Detroit & an MBA from the University of Notre Dame. 

Share This
Like what you see? Receive our blog posts by email!

Like what you see? Receive our blog posts by email!

Sent right to your inbox on Tuesdays!

You have successfully subscribed! Look for our email on Tuesday!