Getting Results with a Lean Management System

Posted on by Kim Barnas

This is the final blog in a four-part series focused on sustaining lean transformation in healthcare organizations. To read the previous blog posts in the series, please follow the links below:

Blog #1 Establishing and Sustaining a Lean Management System

Blog #2 Maintaining Forward Movement

Blog #3 Four Core Elements to Implement a Sustainable Lean Management System 

The rate of change in the business of healthcare has been extraordinarily fast in the past two decades.

The shift to electronic medical records, mergers that create giant health systems, nationwide plans to insure more (or less) people – all these systemic transformations get rolled out with a hopeful promise that healthcare will be better for everyone.

These promises have not been followed with meaningful reporting of metrics or significant results.

In fact, the lofty claims have raised fundamental questions:

  • Can changes in operations management, driven by healthcare administrators, really improve the care patients receive from physicians, nurses, and therapists?
  • Can non-medical managers and executives actually affect patient outcomes with management alone?

Not long ago, as president of hospitals for a large cradle-to-grave health system in Wisconsin, I wrote Beyond Heroes about my hospital’s experience implementing a daily management system. This system, in conjunction with the improvement tools and principles we employed, had a profound effect on patient outcomes, patient satisfaction, and employee engagement. Throughout the hospitals, we improved patient safety, reduced medical and surgical errors, and increased the percentage of caregivers who said they would recommend our hospital as a good place to work.

The daily management system gave administrators and caregivers a method to find the root cause of problems together, every day. Instead of rushing around putting out fires, managers began their days resource planning with front-line staff and addressing issues before they became problems. Quality metrics rose. Costs declined.

After I left that health system, I wanted to know if the results of those early experiments were a fluke. In my new role coaching healthcare executives, I would check in frequently with the early adopters to see how time was testing the system. As new hospitals and health systems adopted daily management, I began asking for their results, as well.

To date, I have gathered data from six very different healthcare organizations in the United States, Canada and the United Kingdom. These health systems – ranging from a small acute-care hospital in Iowa to a Behavioral Health hospital and clinic that is part of America’s largest municipal health system in New York City.

Results across these organizations are eye opening:

  • Using the daily management system, the Behavioral Health hospital in Brooklyn reduced the amount of time a patient had to wait for an appointment from 28 days to four.
  • Western Sussex Hospitals, reduced preventable mortality by 18%.
  • A small hospital in Iowa reduced incidence of patient harm by 40%.

Each of these organizations focused on different quality, satisfaction and cost metrics that were important to their operational success. In some hospitals, the 30-day readmission rate was selected as a critical metric to determine quality. In others, it was infection rates or preventable mortality. So, the results presented here are not apples-to-apples. Instead, the unique metrics for each health system show that leaders were focused on the critical handful of issues most important for their specific needs.

Each of these organizations significantly improved their selected metrics within three critical areas:

  • Patient safety/quality,
  • Patient satisfaction and
  • Employee engagement.

Using a Lean management system, like what I’ve described in this blog series, these executives, leadership teams and frontline staff relied on team-based problem-solving efforts called rapid improvement events or kaizen to achieve results and stabilize or reduce costs. And the improvements stuck in the ensuing days, months, and years.


As we reach the end of this series, let me encourage you with the following.

Lean is a methodology proven to work at healthcare systems of all sizes around the globe – with lasting results. We know hospitals can achieve success with a Lean management system when everyone (the CEO, senior leaders, board members and staff) commit to change and stick with their commitment.

With an organization’s True North (vision, mission, and priorities) and a shared Strategy Deployment System that every staff person comprehends, effective change can begin. 

Avoid distractions and don’t let your plans get derailed. During times of chaos, it’s easy to lose focus or abandon Lean methodologies entirely. There is no faster way to sidetrack progress than to let a single event disrupt your weeks, months and years of planning and execution. Instead of abandoning the work, apply Lean thinking to the crisis du jour. You’ll find new strength in managing issues and putting out fires by implementing Lean tools and expertise to solve the problem at hand.

While your journey will be long, it will most certainly produce sustainable results when Lean is in place as your guide.

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