Living the Lean Life - Lean is Just a Tool

By Carrie Donovan posted 12-23-2014 02:10 PM


I have been told that I am naïve and a bit of a fool to make the statement that the future of healthcare lies in learning lean.  While I will not deny my occasional naiveté and down-right foolishness, I stand by my statement whole-heartedly. 

Why?  Lean is just a tool right?  Yes, lean is a tool.  And just like a hammer can be used to build a table, lean can be used to build pockets of excellence.   Many other quality tools such as PDCA, Six-Sigma and even Project Management can get you improvement results.   Many organizations have seen projects show great success using these tools.

 A hammer can also be used to destroy or even hurt people.  These quality tools can also be used to create cultures of blame and shame, or even to lull us into a false sense of accomplishment by creating small pockets of excellence while still allowing the overall decline of value for patients, their families and our staffs.  

I believe that those individuals that tell me lean is just a tool are right.  I also believe that the lean tools, applied with the principles of respect for people and continuous improvement, within a business management system to support continuous improvement, will change healthcare. 

What do I mean by continuous improvement and a business management system to support it?  I mean the humble belief by top leaders that we will always have opportunities to improve, that we are never done working toward an ideal.  I mean an organizational structure that makes it easy to identify opportunities for improvement through levels of visual management and accountability; and a vision that gets the whole organization rowing in the same direction to turn the Titanic away from the iceberg.

In short I mean changing the paradigm of healthcare.  No tool alone will do that. Only dedicated, humble leaders and hard-working caregivers with a vision, accountability and a good hammer will do that.

1 comment



08-30-2016 12:31 PM

The Institute for Healthcare has an interesting White Paper providing a brief overview of the issues and some key definitions, followed by more detailed descriptions of Lean and the IHI approach to quality improvement (IHI-QI). See: Scoville R, Little K. Comparing Lean and Quality Improvement. IHI White Paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2014. (Available at