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Lean and the perfect patient experience
  1. C Craig Blackmore,
  2. Gary S Kaplan
  1. Center for Health Care Improvement Science, Virginia Mason Health System, Seattle, Washington, USA
  1. Correspondence to Dr C Craig Blackmore, Virginia Mason Health System, 1202 Terry Avenue, #324, Seattle, Washington, 98101, USA; Craig.Blackmore{at}

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The term Lean means different things to different people. At Virginia Mason, it is applied to the management system based on the systematic identification and elimination of waste, defined as any activity that does not add value from the standpoint of the customer. First developed in manufacturing, and championed by the Toyota Motor Corporation, efforts to introduce Lean into healthcare have been met with some scepticism. ‘People are not cars’ has been the refrain of those unwilling to view healthcare as made up of processes that produce products and services, and that is thus amenable to improvement.

Healthcare, of course, is different from manufacturing, in that it is not simply the final product that is important to the customers, but also the patient and family experience of care. Also adding complexity in healthcare is the presence of multiple customers, the patient most importantly, and the healthcare providers and staff, and the healthcare institution itself. In addition, in most healthcare systems, there is a disconnect between those who pay for healthcare and the patients who receive it, thus generating an additional healthcare customer or stakeholder, the source of funding, whether it be the government, employer or insurance company. Clearly, the application of Lean in the healthcare setting is …

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