As I paid for the routine maintenance at my local car dealer’s service department, I noticed a colorful item on the counter, sporting the colors red, yellow and green.


It was a tread example showing, at the top, the importance of good tire grooves and the risk of hydroplaning, and, at the bottom, examples of various thickness of tread with recommendations for appropriate response.


The tires on my car happened to fall in the Yellow zone.

I thought to myself:

  • Should I just get them replaced today? I have some time to react.
  • Am I losing some money by not using the full tread life of the tire?
  • How much risk do I tolerate if I wait until the red zone?

Not having the time to wait longer due to other commitments, I opted to delay replacing them to another day.  One more item on the to-do list, but I must resolve the issue before I am driving in an unsafe condition.

What would I have done if I had not known the status of my tires until I was in the red zone?  Would I have found the time today and impacted other commitments?  Would I drive with unsafe tires, hoping that I don’t have an accident hydroplaning in a heavy rain?

I find situations in my Lean Healthcare work that prompt a similar mode of thinking.

Working with a hospital on patient throughput, I found that bed control would go down to the ED to check for admit holds.

  • If there were admit holds, they would round the floors to check for available or pending discharge beds.
  • If there were not admit holds, they had time to get a cup of coffee before heading back to the patient flow office to await bed requests.


This obviously put them in the Red Zone on a daily basis.  Nothing was being done to prevent it. Green was really “not red”, no immediate crisis.

Working the Yellow Zone

A different mindset is to put more effort into situational awareness, and work to resolve issues before they become a bigger problem.


In this scenario, by working the situation to prevent the crisis (ED holds/no beds) from occurring, there is rarely the need for the frantic scramble to find a bed when there is an ED admit hold.

Green is really “ready to respond” when the need occurs.

But are there other Lean Healthcare examples?

  • Patient ready for OR in the pre-op area. Does the circulating nurse have to troubleshoot issues with the patient being ready-to-roll, or just validate that pre-op is complete?
  • Are forms replenished when low, or does staff wait until there are none to notify a unit clerk to reorder?

I wrote in a past blog, Problem Solving Hero, about a similar situation with lab reagents.

So what did I do with my tires?

As luck would have it, I received a tire coupon in the mail for “Buy 3, get 1 free” at my local dealer.  So, by being aware of the current state before it was a full-blown crisis, I saved 25% on a new set of tires from the dealer!

Richard Tucker, Vice President for Lean Healthcare and Process Improvement Training at HPPToday’s blog was written by Richard Tucker, vice president with HPP.

Richard serves as a coach, facilitator, and project manager for healthcare clients in the training and implementation of Lean Healthcare tools and Lean management systems. Prior to joining HPP, Richard had more than 16 years of business and industry experience in operational and leadership positions.  In addition to his ongoing support of healthcare organizations in their lean journey, Richard is a founding faculty member of Belmont University’s Lean Healthcare Certificate Program. Richard’s educational background includes BS and MS degrees from Tennessee Technological University in Cookeville, Tennessee. Richard has attended formal training courses in Lean Manufacturing, Leadership Development, and Shainin Statistical Problem Solving.

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