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Practical Tips for Applying Lean Thinking Principles and Tools to Healthcare Improvement Team

Posted on February 22, 2016 in Lean

The essence of Lean Thinking is to enhanced value for customers with optimized resources by minimizing waste. Lean Thinking requires an organization to focus on its key processes to continually improve and increase value to its customer, in healthcare term, the PATIENT.

Both external (patients) and internal (provision processes) customers are vital to the healthcare facilities. For example, the Operating Room (OR) is an internal customer of the operation processing department (OPD) as the OPD is an internal supplier of instruments, supplies, and equipment. Serious Lean implements strive to fulfil external and internal customers, with excellent service (better, faster, easier, and cheaper).

For Lean Thinking to work effectively, healthcare leaders must develop a positive atmosphere whereby problems are recognized as improvement opportunities. Healthcare associates are not ‘attacked’ as the problems - they are problem solvers, and focus is on finding solutions rather than blaming.

Lean Thinking helps improve processes with problem solving principle and tools to identify and reduce waste in a Lean continual improvement project. A Lean project could potentially improve patient, surgeon, and staff satisfaction by addressing such problems such as:
  • Ineffective use of resources,
  • Excessive movement and transportation
  • Excessive waiting and idling time
  • Misplaced or lost instrumentation
  • Error in dispensing of medication, diagnosis and corrective surgeries

Lean Thinking Principles
Lean Thinking principle has its roots in the scientific method of Plan-Do-Check-Act (PDCA) cycle. The PDCA cycle is a 4-step model for carrying out effective change:
  • Plan: recognize an opportunity and plan the change
  • Do: try out and implement the change
  • Check: review the tryout results and the effect of the solution
  • Act: take action for the implementation; results NG - repeat the cycle with  a different plan; results OK - integrate into the work process

The PDCA cycle is repeated over and over to continually improve processes. Thus, PDCA cycle is a vital principle in lean team improvement projects.

Lean Thinking Tools 

1.  Effective Team:
Effective team needs a sponsor, a leader, and a facilitator. If the team encounters roadblocks that prevent progress, the sponsor is responsible for removing those roadblocks. The sponsor is the go-to person if the team cannot move forward.
The team leader is responsible for keeping the team focused and productive and ultimately is responsible for the success of the project. If additional resources are needed, the leader obtains them.  The leader is also responsible for reporting progress to those charged with managing and supporting the Lean process in the organization. The leader is focused on strategy and resources and deals with questions such as:
  • What should the team do next?
  • Who can help us with this part of the project?
The facilitator is concerned with how the team works and ensuring that progress is made at each team meeting. Using the relevant technique at the proper time is part of the facilitator's responsibility. Some of his tasks include the following: 
  • Prepare for the meeting 
  • Visualized the topic being discussed in words and diagrams 
  • Ask questions
  • Use flow diagrams
  • Define work area layouts clearly   
  • Optimize usage of meeting time carefully   

2. Standard problem solving structured flow is essential. This flow consists of 8 steps:
  1. Definitions and scope the problem statement
  2. Identify current processes and related issues with a value stream map
  3. Determine causes of problems with cause-and-effect chart
  4. Sort out problems into similarity groupings with affinity diagram
  5. Prioritize and rank countermeasures with ease-effect matrix chart
  6. Coordinate improvement activities with the Action Plan
  7. Monitor status of key action items during implementation
  8. Develop plans for sustenance of gains and document, replicate the learning experience


The strategies to adopt Lean Thinking are simple and direct. Guided by Lean principles and tools, teams can solve operational problems which are helpful to associates, patients, and to the healthcare facility. Associates now have the channel to offer their opinions and useful ideas in a transparent, positive, and proper environment where their input is valued and acted on. The healthcare facility can profit by mainly harnessing the abundant resources of abilities and experience of its associates to address its most trying problems.

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