The quest to increase efficiency and lower healthcare costs has led many hospital and healthcare system leaders to explore innovative management strategies, often from other industries. Lean—based on the approach developed for the Japanese auto manufacturer Toyota Production System—has gained traction as a continuous quality improvement strategy with potential to improve care delivery. To answer questions for the Agency for Healthcare Research and Quality about how Lean techniques can contribute to sustainable quality and efficiency gains in care delivery, AIR helped fill knowledge gaps about how a healthcare organization’s environment, structure, and culture can inhibit or enhance successful diffusion and integration of Lean training, tools, and activities.
After reviewing the literature in this field, AIR, in partnership with the Mayo Clinic and the Urban Institute, conducted rigorous case studies of 12 Lean projects implemented in five different health care settings to advance understanding of the barriers and facilitators to using Lean techniques in healthcare settings. Among key factors contributing to Lean success were top organizational leaders’ commitment and support; previous experiences with quality improvement initiatives; aligning Lean implementation with the organizational mission and vision; and dedicating resources—including assigning experts—to Lean.