Case Studies

Lean Leadership


When one Medical Center found that they were not able to sustain the performance gains they had achieved with their initial work in Lean, they issued a competitive procurement to find a provider who would use a "True Lean" approach to truly transform their entire organization and develop a culture of continuous improvement.


The OPS team worked with the Medical Center's Leadership team and Lean Office personnel in three key areas: Leadership Development, Employee Training, and Improvement Activities, which have been implemented in a coordinated and mutually supportive manner to accelerate implementation and provide sustainability. Over the past few years, this Medical Center is well launched on the path to operational excellence, based on the principles, philosophies, and appropriate tools of the Toyota Production System adapted to healthcare. This approach offers an effective model for building and sustaining a culture of continuous improvement in healthcare.


  • Leadership Development.
    The Executive Team developed and is implementing the Medical Center Management System, with the goal of:

    • All employees performing continuous, incremental, and measurable process improvement on their work.
    • This model is an important element in the transformation process, as it provides the Executive Leadership Team and all employees with a powerful, straightforward representation of the improvement processes, and how they fit together in mutual support. It is essential that this model be developed by the Executive Leadership Team, and that every leader reinforce it in all interactions. The principles and philosophies in this Center's model are:

      Veteran Centric
      Employee Development & Engagement
      Standardized Processing
      Standardized Problem Solving
      Defect Free
      Without Waste
      Continuous Flow
    • Achieving improvement in the work place requires making these principles real for all employees, helping them understand the expectations, and learning the tools they will need, including how to use them to achieve the goal. For example, the Philosophies of Defect Free and Without Waste are further defined as:

      At the point of processing, delivery of care/service will be performed with no harm in a safe and efficient manner with the minimal use of material, energy, and other resources, including human.

    • The tools currently used to achieve this are the Value Stream Analysis Process, 5S, and Visual Management.

  • Employee Training.
    Process improvement occurs in the workplace, not in the classroom, so the training at this Medical Center is very hands-on and action oriented, with the goal of enabling employees to engage in front-line activities as soon as possible. Classes in an Introduction to Lean, Problem Solving I and Problem Solving II are one-to-two days each, and have a strong "do it" flavor.

  • Improvement Activities.
    This Medical Center has achieved significant and measurable performance improvement by using the tools of A3 Problem Solving and the Value Stream Analysis Process (VSAP). Process improvement projects have been conducted in Primary Care, Behavioral Health, Nursing, Urgent Care, Pharmacy, Laboratory, Radiology, and support areas including the Mail Room, Cafeteria, and Purchasing. Projects are thoughtfully executed, with appropriate Executive Leadership engagement.