Book Talk: Lean Hospitals

Since its publication last summer, Lean Hospitals by Mark Graban has been one of our best-sellers. The book explains why and how lean can be used to improve safety, quality, and efficiency in a healthcare setting.

Many of you may know Mark as the author of the Lean Blog.

For this week’s book talk, I chatted with Mark about reaction to the book, as well as lean in healthcare. He said he has been getting a lot of feedback on the book, the most encouraging regarding senior executives (the target market) who said the book helped them understand lean is not just a set of tools (one of the book’s key points).

He commented, “I do get a lot of feedback in particular about Chapter 10, which talks about engaging and leading employees. People are really interested in engaging staff in continuous improvement. How do you motivate people to want to participate in lean efforts? The whole discussion of standardized work as a management system is helpful. It is not just a matter of writing documentation, but how do you manage, how do you engage people?”

“A pleasant surprise is the amount of contact I’m getting from people around the world about the book,” he added. “In the last couple of weeks, I was contacted by somebody in Sweden who bought 100 copies to do training. There was a person in a hospital in Netherlands. It’s real exciting to see, and a gauge of how much lean thinking in healthcare is spreading throughout the world.”

Mark says he is very busy with his consulting work, even in the current economy. “In a way, (the economy) makes the case for using lean more compelling. While there has always been a focus on both operational and service improvements, and return on improvements, there is a little bit more focus now on hard-dollar-return on improvements.”

In addition, “One other situation hospitals are somewhat being forced into: If you look at capital expansion, one solution to problems in healthcare is ‘we just need more space.’ In the last five to 10 years, hospitals have learned they can actually use lean methods to make better use of the space they have. Now some hospitals are being forced into that. Lean is an alternative to improve productivity and service without that expansion.”

What progress are we making in seeing lean applied to healthcare? “In terms of the adoption curve, I think we’re still in the upward part of the curve. We’re beyond the area where people can credibly say this won’t work in healthcare. We’ve got the wave of hospitals, the early adopters, and now there is the wave of hospitals seeing what others have done, saying ‘OK, this does work.’ It’s hard to say what percentage of hospitals are using lean. There is not good data out there…

“It is certainly not the conventional wisdom in the industry yet. There are certain departments. We are right on the verge of it becoming the accepted notion in the laboratory profession. Lean laboratories significantly outperform traditional hospital laboratories. For hospitals as a whole, we are still educating people, still selling the notion of lean.”