Reconstituting lean in healthcare: From waste elimination toward ‘queue-less’ patient-focused care

With ultra-short sightlines to its patient-customers, healthcare should pursue lean in its own way rather than follow the often wayward lean practices of manufacturing, a sector in which few people ever see real customers. Because of the distance in manufacturing from end customers, this sector’s lean practices usually focus inward on operational efficiency through waste elimination. The nature of healthcare—with customers up close and immediate—calls for elevating its lean efforts toward customer-focused lean effectiveness: flexibly quick response along the multiple flow paths leading to and involving patients. This article illustrates that approach to lean by drawing from a case study in which widely scattered heart attack patients were transported to a central treatment hospital in a system-wide, highly coordinated program of quick response. This article shows that the keys to success—including high rates of saving lives and lean healthcare in general—boil down to just five lean methodologies, each focused on quick response. Lean healthcare, when practiced in this way, becomes deserving of status as a fixture in strategic management of the enterprise.