The Lean Healthcare method in healthcare management

In recent years, organisations in the global healthcare sector have opted to apply the tools of the Lean Management methodology with the aim of improving healthcare processes and the results of their daily operations, both in terms of health and in terms of optimising available resources and capacity by reducing and eliminating waste. In this post, we would like to explain what Lean Healthcare is, what its objectives and benefits are and how it is applied to the healthcare system.



What is the LEAN method?

The Lean method consists of the search for continuous improvement in processes in order to achieve the best quality while minimising costs, with the patient as the pivot from which everything else revolves.

This methodology combines rapid implementation improvements with the search for a transformation of the organisational culture based on respect for the workplace and people, with the ultimate aim of having a set of practices and a management system with quality and safety as a priority. In other words: doing more with less. 


“Lean is a philosophy focused on meeting customer needs satisfactorily, using all available production resources with minimum waste, with the highest quality and at the lowest cost.”


In the healthcare field specifically, we are talking about a system for improving organisational processes, both healthcare and non-healthcare, which incorporates changes in the organisation of work and in the management of materials to achieve improvements in different areas such as healthcare quality, patient and professional safety or the reduction of process times. 





The origin of the LEAN method

The term Lean Manufacturing was coined in 1990 by the authors of the book “The Machine that Changed the World”. However, its origin lies in the 50’s in Japan, in the philosophy applied to the production process developed by Toyota. What is this philosophy based on? On being effective, efficient and flexible to adapt to the changing needs of the environment and uncertainty from a damage minimisation perspective.


How is this achieved?
By involving all members of a team to rapidly improve production processes, eliminating redundancies and activities that do not generate added value. Action orientation is also key, as is the involvement of the entire team.


Therefore, from the outset, the LEAN methodology is based on a process optimisation system, focused on orienting processes towards value creation and the elimination of waste, in order to achieve smooth processes. 





What is the objective of LEAN in hospitals?

Healthcare centres are complex organisations that generate many inefficiencies due to unnecessary processes, disorder in the workplace, lack of availability of material or equipment when required, staff stress, lack of communication between different areas or different professionals, etc. 

The ultimate goal of Lean is to develop a teamwork strategy to solve problems and a culture of continuous improvement. In this sense, the Lean methodology proposes a new way of managing processes to focus on operational efficiency (increasing quality, reducing time and costs), to meet more and better with those who are part of the services and with the expectations of the users of the health system.

Applied to a hospital or health centre, this form of organisation and management seeks to reduce the waste of talent, waiting times, excessive procedures and bureaucracy, optimise inventory, the transport of materials and the mobility of professionals around the health centres, put an end to the overabundance of diagnostic tests, surgical interventions and visits, and eliminate diagnostic errors. The aim is to be able to care for the maximum number of patients at an optimal cost.






Benefits of applying the Lean system

As we said, the origin of this methodology dates back to the Toyota company during the period of World War II. However, it has been in the last decade in Spain, and since the new millennium in the rest of the world, that it has been applied to the health sector.

Particularly in the health sector it is very beneficial, as it is a complex sector, where circuits cross and many people are involved, it is very effective in achieving order and efficiency. Therefore, the main benefits of applying Lean in the health sector are:


  • Improving the quality of medical care provided and patient satisfaction, as it is a management system that puts the patient at the centre and facilitates the transformation of the “patient journey”, from admission to discharge. It pursues “0” error and excellence in patient service, reducing admission/appointment times, visits and consultations, average length of stay, etc.
  • It increases the satisfaction of healthcare staff, as it simplifies processes and eliminates excesses, and reduces the workload.
  • It ensures the sustainability of the improvements to be achieved with autonomous teams in the maintenance and improvement of the same.


“The LEAN method reduces waiting times, waiting lists and inventories, and increases the satisfaction of patients and healthcare staff and the capacity of the care services.”





Lean Management principles applied to the hospital sector

Applied to hospitals and healthcare centres in general, Lean Hospital Management refers to the development and improvement of hospital processes, and its main principles can be summarised as follows:


  • Identifying added value by patients and by groups. Hospitals deal with patients, and it is on them that the focus should be placed, but also with their relatives and healthcare staff. Each of them will have a different point of view regarding the added value they want to receive. For example, we can pay special attention to the information they provide us with through surveys, complaints, suggestions, claims, personal interviews, information gathered in daily dealings with the patient, etc. and thus offer a care service that provides real value.


  • Understanding the value chain map. Identify problems and inefficiencies in the transmission of value in order to detect opportunities for improvement and lay the foundations for the optimisation and implementation of this methodology.


  • Eliminate waste and superfluous expenses. To this end, each of the hospital’s departments must be assessed as a whole and not act individually.


  • Simplify the tasks of professionals: In addition to avoidable costs, we can rely on Lean Management to say goodbye to excessive bureaucracy and cumbersome processes that steal time and resources.


  • Continuous improvement. To achieve maximum optimisation of hospital operations on a daily basis and to drive continuous improvement throughout the hospital. This process is one of the cornerstones of the Lean system and is known as Kaizen, which in Japanese means “continuous improvement”. The idea: a small, creative, low-cost, low-risk, low-risk and easy-to-implement improvement to work better every day.


  • Involvement of all staff: The people of an organisation are the centre and the crucial point of the Lean Healthcare method, as they are responsible for detecting areas of improvement in which to add value and find solutions.





The LEAN method in the healthcare sector

The concept of Lean Healthcare has begun to resonate strongly as a trend in recent years following the impact of the Covid-19 crisis on healthcare institutions. 

The system’s indebtedness, socio-economic uncertainty, the need to rationalise costs and care work, and sustainability are all short- and long-term issues.


The question is: can Lean Healthcare be a good strategy to face the times ahead?

And the answer is none other than YES, in capital letters.


For example, in Spain, Lean Healthcare is already known and has been developed in pioneering entities in the implementation of the method such as the Calahorra Hospital Foundation, the Consorci Sanitari Integral in Hospitalet de Llobregat and the Hospital de L’Aliança in Barcelona.

Another centre where this system is going from strength to strength is the Hospital Universitari de Bellvitge, whose objective is to implement the Lean methodology in its General Management and all the departments of the centre. They follow a scorecard under the guidance of the strategic plan with indicators of the objectives, setting out first strategic lines, then strategic objectives and finally indicators, to find out whether or not the objectives have been met. 

They all come to the same conclusion: the application of Lean Healthcare is viable because it is economical and because it offers real results in a short time. With the best hospital equipment and the right staff, no major financial investment is necessary, but “only” a change of mentality and a common and continuous commitment.



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