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Clinical Consulting: The Intersection of Lean Thinking and Healthcare Technology Planning

| Debbie Gregory

As the landscape in healthcare is continually changing, increasing pressures for hospitals to perform leaner is becoming commonplace.

By definition, lean thinking is the concept of finding value and eliminating waste in a process. Waste is anything that does not bring value to your “customer” or the end recipient of your service. Lean comes from a Japanese manufacturing concept created by the Toyota Production System. By adjusting operations on the frontlines, organizations are able to realize financial benefits, operational efficiencies, and improve patient care delivery.

Benchmarking these findings creates a standard that can show improvement or decline in performance. When hospital staff have the ability to benchmark processes, they are able to measure their performance against a standard and evaluate the effectiveness of their process. Tracking outcomes are imperative to lean implementation. Data demonstrates results therefore validating buy-in and outcomes.

So how can we apply lean thinking to healthcare technology planning? As hospitals continue to spend increased amounts of capital and operating dollars towards new and expanding technology systems it is important to begin incorporating lean processes into early planning. Developing a healthcare technology masterplan is the ultimate goal, but at the minimum include this five step approach in early planning:

1. Assess the current state of that technology system

a. What features and functionality are currently being used – Purchased vs utilized?

b. What service contracts and warranties are currently associated with the system?

c. What is the current financial investment made in the system?

2. Document current workflow related to use of the system

a. Shadow end users to document and verify utilization of purchased features and functionality (compare to the assessment done in #1)

b. Involve an in house lean team to evaluate current state

c. Identify areas for improvement and optimization

3. Plan for future expansion or new system

a. What features and functionality are desired with the new or expanded system?

b. Create a process map to determine if there is functionality overlap between systems? Example – Patient Entertainment vs Nurse Call – some systems overlap functionality

c. Develop complementary functionality with existing systems as opposed to competing or redundant functionality

4. Align the budget to capture all operating costs, warranties, service agreements, licensing agreements and any hidden costs such as integration costs with other systems. (Note: additional licensing or middleware may be additional costs)

5. Design technology systems and technology integrations to align and support lean workflow processes to maximize system investment, best practice, and improved clinical outcomes. This should be initiated as an ongoing quality improvement standard of practice throughout the facility.

Going lean in an organization requires buy-in from leadership and an enterprise wide commitment. With a “lean thinking culture”, leaders can continually drive this initiative within the organization. As discussed, assimilation and alignment with people, place, and process is crucial to the success of lean implementation. This leads to continuous improvement, a state of perpetual process evaluation, seeking new solutions, benchmarking outcomes and ultimately pursuing perfection.

Want to engage you team in Lean Thinking?

1. Inspire your team – Take on a Lean Project from your daily activities. Set the tone, share your accomplishments, and challenge the other members of your team.

2. Start simple – Find an achievable task that can be improved and establish metrics around it.

3. Create goals – Find your biggest setbacks, determine your “customer’s” needs, and express your desired outcome.

4. Look for opportunities – Find activities with high variability. High variability usually means there are multiple ways a process is being accomplished. Find the best process and standardize.

5. Engage in resources – Consider becoming Lean Six Sigma Certified and learn best practices for leading a Lean Six Sigma Project.

Hospitals can no longer afford to maintain current processes. The potential for financial savings, staff utilization, and quality improvement is too great to be missed. For questions about implementing Lean in healthcare, feel free to contact Anna Buckner at

Questions related to this article may be directed to the authors, Debbie Gregory, RN, BSN  ( or Anna Buckner, Lean Six Sigma Green Belt Certified (