Results from Lean in Healthcare

Screen Shot 2016-06-04 at 5.47.47 PMFrom Chapter 1 of the revised 3rd edition, released in June 2016:

Excerpt from Lean Hospitals, 3rd Revised Edition

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…there are now many examples of the positive impact Lean is having in hospitals throughout the world. As a sample, Lean methods have resulted in improvements to:

Safety and Quality

Reduced central-line-associated bloodstream infections by 76%, reducing patient deaths from such infections by 95% and saving $1 million—Allegheny Hospital, Pennsylvania[i]

Reduced hospital acquired infections, saving 57 lives, reducing ICU length of stay and reducing costs by over $5 million over two years —University of Pennsylvania Medical Center[ii]

Reduced readmission rates for chronic obstructive pulmonary disease (COPD) patients by 48%—UPMC St. Margaret Hospital, Pennsylvania[iii]

Reduced falls by 22%, reducing costs by more than $500,000 – Hanover Regional Medical Center, North Carolina[iv]

Reduced pressure ulcers by 56% in three pilot areas over two years, with a 30% decrease system-wide – BJC Healthcare, Missouri[v]

Avoidance of 87 readmissions for congestive heart failure in 12 months across four hospitals, saving $830,000 – Four hospitals in California[vi]

Reduced sepsis mortality from 24% to 9%, reducing the average cost per case from $15,772 to $12,771 – Presence Health, Illinois[vii]


Waiting Times and Length of Stay

Reduced patient waiting time for non-emergent orthopedic surgery from 14 weeks to 31 hours (from first call to surgery); improved inpatient satisfaction scores from 68% “very satisfied” to 90%—ThedaCare, Wisconsin[viii]

Reduced emergency patient length of stay by 29% and avoided $1.25 million in new emergency department (ED) construction—Avera McKennan, South Dakota[ix]

Reduced waiting times for screening colonoscopies from 6 weeks to less than 24 hours while reducing cost per patient by 9.5% — Palo Alto Medical Foundation, California[x]

Increased the percentage of atrial fibrillation patients treated within 40 days from 11% to 94% HealthEast, Minnesota[xi]



Reduced turnaround time for clinical laboratory results by 60% in 2004 without adding head count or new instrumentation; further reduced times by another 33% from 2008 to 2010—Alegent Health, Nebraska[xii], [xiii]

Reduced instrument decontamination and sterilization cycle time by 54% while improving productivity by 16%—Kingston General Hospital, Ontario[xiv]

Reduced late surgery starts from 50% to 30%, reduced rescheduled procedures from 20% to 4.4%, while increasing cases per month from 329 to 351 – New York City Health and Hospitals Corporation[xv]

Reducing O.R. turnover time from 60 minutes to 30 minutes, increasing utilization rates from 25% to 65% and achieving 100% on time starts in a pilot area – Guangdong Provincial Hospital of Traditional Chinese Medicine, China[xvi]



Improved patient / family satisfaction rates in the NICU from 45th percentile to 99th percentile – Franciscan St. Francis, Indianapolis[xvii]

Improved physician satisfaction from 63rd percentile to 87th, being highest rated in overall care among 170 California medical groups for two consecutive years – Sutter Gould Medical Foundation, California[xviii], [xix]

Improved emergency department patient satisfaction from 5th percentile to 98th percentile in just four months (through door-to-doc times falling from 67 to 18 minutes) – Sumner Regional Medical Center, Tennessee.[xx]



Bottom-line benefit of almost $200 million over seven years, while achieving “the lowest observed-to-expected mortality among the academic health center members of the University Health system Consortium in 2011” and avoiding layoffs—Denver Health, Colorado[xxi]

Avoidance of $180 million in capital spending through Lean improvements—Seattle Children’s Hospital, Washington[xxii]

Improved operating margin by 44%, from 1.70% in fiscal year 2011 to 3.06% in fiscal year 2014 —HealthEast, Minnesota[xxiii]

[i]McCarthy, Douglas, and David Blumenthal, M.D., “Committed to Safety: Ten Case Studies on Reducing Harm to Patients,” The Commonwealth Fund,–ten-case-studies-on-reducing-harm-to-patients (accessed March 26 ,2015).

[ii] Martin LA, Neumann CW, Mountford J, Bisognano M, Nolan TW.Increasing Efficiency and Enhancing Value in Health Care: Ways to Achieve Savings in Operating Costs per Year. IHI Innovation Series white paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2009.

[iii] California Health Advocates, “Creative Interventions Reduce Hospital Readmissions for Medicare Beneficiaries,” October 7, 2010, (accessed March 26, 2015).

[iv] Barto, Jack, “CEO Blog: Avoiding patient falls: Where patient safety meets cost reduction,” (accessed September 12, 2015).

[v] Lean Tools Used to Reduce Pressure Ulcers,

[vi] Wu, Shinyi, Pai Liu, and David Belson, “Multiple-Hospital Lean Initiative to Improve Congestive Heart Failure Care: A Mixed-Methods Evaluation,” Journal of the Society for Healthcare Improvement Professionals, (accessed September 12, 2015).

[vii] Rice, Sabriya,”Learning to be Lean,” (accessed October 22, 2015).

[viii] Toussaint, John, and Roger Gerard, On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry (Cambridge, MA: Lean Enterprise Institute, 2010), 29.

[ix] ValuMetrix Services, “Avera McKennan,” Case Study, (accessed March 26, 2015).

[x] Maser, Ben and Osman Akhtar, “PAMF’s Ambulatory Surgery Center: A Value Stream Approach to Improvement,” Presentation at 2015 Lean Healthcare Transformation Summit, June 2015.


[xii] ValuMetrix Services, “Clinical Laboratory Improves Turnaround Time by 60%,” Case Study, (accessed March 26, 2015).

[xiii] Ford, Anne, “Thanks to Weak Economy and More, Efficiency Is King,” CAP Today, April 2010, (accessed March 26, 2015).

[xiv] Lefteroff, Lewis, and Mark Graban, “Lean and Process Excellence at Kingston General,” SME Lean Manufacturing 2008, 53.

[xv] Rice.

[xvi] Guo, Jinshai, Shijun Ma, and Xun Zhang, “Lean management to transform a Chinese hospital,” (accessed October 27, 2015).

[xvii] Graban, Mark, “Gemba in the NICU: More Notes from our “Kaizen Live” Experience at Franciscan,” (accessed September 12, 2015).

[xviii] Graban, Mark, “Podcast #230 – Paul DeChant, MD, MBA on Reducing Burnout Through Lean,” (accessed September 20, 2015).

[xix] Consumer Reports Health, “How Good Is Your Doctor?,” Special Report for California Residents, February, 2015.

[xx] No author, “Slash door-to-doc time, boost patient satisfaction with staff-driven improvement effort,” ED Manag. 2011 Jun;23(6):70-1.

[xxi] Gabow, Patricia, The Lean Prescription: Powerful Medicine for an Ailing Health System (New York: Productivity Press, 2014), xix.

[xxii] Weed, Julie, “Factory Efficiency Comes to the Hospital,” New York Times,, July 10, 2010 (accessed March 26, 2015).