Volume 1, Issue 3 p. 191-199
Transforming Hospital Care

Lean health care: What can hospitals learn from a world-class automaker?

Christopher S. Kim MD, MBA

Corresponding Author

Christopher S. Kim MD, MBA

Division of General Internal Medicine, University of Michigan, Ann Arbor, Michigan

Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan

University of Michigan, Division of General Medicine, Department of Internal Medicine, 3119 Taubman Center, Box 0376, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0376Search for more papers by this author
David A. Spahlinger MD

David A. Spahlinger MD

Division of General Internal Medicine, University of Michigan, Ann Arbor, Michigan

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Jeanne M. Kin JD, MHA

Jeanne M. Kin JD, MHA

Department of Internal Medicine, Medical School Administration, University of Michigan, Ann Arbor, Michigan

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John E. Billi MD

John E. Billi MD

Division of General Internal Medicine, University of Michigan, Ann Arbor, Michigan

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First published: 05 June 2006
Citations: 238

Abstract

BACKGROUND

With health care costs continuing to rise, a variety of process improvement methodologies have been proposed to address the reported inefficiencies in health care delivery. Lean production is one such method. The management philosophy and tools of lean production come from the manufacturing industry, where they were pioneered by Toyota Motor Corporation, which is viewed as the leader in utilizing these performance improvement methods. Lean has already enjoyed tremendous success in improving quality and efficiency in both the manufacturing and the service sector industries.

RESULTS

Health care systems have just begun to utilize lean methods, with reports of improvements just beginning to appear in the literature. We describe some of the basic philosophy and principles of lean production methods and how these concepts can be applied in the health care environment. We describe some of the early success stories and ongoing endeavors of lean production in various health care organizations. We believe the hospital is an ideal setting for use of the lean production method, which could significantly affect how health care is delivered to patients.

CONCLUSIONS

We conclude by discussing some of the potential challenges in introducing and implementing lean production methods in the health care environment. Lean production is a novel approach to delivering high-quality and efficient care to patients, and we believe that the health care sector can anticipate the same high level of success that the manufacturing and service industries have achieved using this approach. Hospitalists are primed to take action in delivering care of greater quality with more efficiency by applying these new principles in the hospital setting. Journal of Hospital Medicine 2006;1:191–199. © 2006 Society of Hospital Medicine.