Lean Building Design

This Hot Topic is Lean Building Design. This topic complement’s the upcoming Centre for Health Care Management seminar Applying Lean Thinking and Principles in Building Design with Bob Breen, Chief Project Officer of the BC Children’s and BC Women’s Redevelopment Project. To learn more about the seminar or to register visit the information page.

Introduction to Lean

Lean is a set of tools and a group of principles and concepts that guide how an organization can most efficiently use resources while removing non-value added process from the delivery of customer goods and services (Grabban, 2011). It is comprised of five steps that focus on decreasing resource usage while increasing employee knowledge utilization and improving value to customers. The five steps are:

  1. Specify value from the standpoint of the end customer by product family;
  2. Identify all the steps in the value stream for each product family, eliminating whenever possible those steps that do not create value;
  3. Make the value-creating steps occur in tight sequence so the product will flow smoothly toward the customer;
  4. As flow is introduced, let customers pull value from the next upstream activity;
  5. As value is specified, value streams are identified, wasted steps are removed, and flow and pull are introduced, begin the process again and continue it until a state of perfection is reached in which perfect value is created with no waste (Lean Enterprise Institute, 2009).

Lean thinking is designed to help organizations achieve greater customer satisfaction while using less human capital, space, effort, equipment, and time (Grabban, 2011). Within a healthcare context, Lean refers to the elimination of unnecessary cost and risk associated with accessing care. While a Lean approach to healthcare sounds obvious, there are roadblocks to achieving Lean environments. Traditional processes have evolved, reporting requirements have altered, and new technologies have developed. Often these advancements occur asynchronously, causing interdependent processes to no longer function smoothly together. Lean tools and practices can help managers overcome obstacles to the provision of exceptional customer value (Eaton, 2008).

Eaton, M. (2008). Lean for Practitioners – An Introduction to Lean for Healthcare Organisations. St Albens, Herts: Ecademy Press Limited.
Grabban, M. (2011). Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction. (2nd ed.) New York, NY: Productivity Press.
Lean Enterprise Institute. (2009). Principles of Lean. Cambridge, MA. Retrieved from http://www.lean.org/whatslean/principles.cfm.

Selected Publications

The READ Portal has posted several papers on topics in Lean. Visit the Process Improvement tag page to see all the existing READ posts about the topic. Additionally, the following resources were selected by Bob Breen and the CHCM Librarian as introductory readings to the topic. While some of these resources require subscription, many are open access. For more information, please contact your institution’s library or email librarian@chcm.ubc.ca for access.
Kenney, C. (2011). Virginia Mason Medical Center’s Pursuit of the Perfect Patient Experience. New York, NY; CRC Press.

Wellman, J., Hagan, P., & Jeffries, H. (2011). Driving Culture Change to Increase Value. New York, NY; CRC Press.

Fine, B.A., Golden, B., Hannam, R., & Morra, D. (2009). Leading Lean: A Canadian Healthcare Leader’s Guide. Healthcare Quarterly, 12:(3). Available at http://schowengerdtconsulting.com/Administrative/ReadingList/Leading%20Lean-%20A%20Canadian%20Health%20Care%20Leader%27s%20Guide.pdf.

Jackson, K., & Woeste, L.A., (2008). Using Lean Six Sigma to Reduce Patient Wait Times. Lab Medicine, 39:(3). Available at http://labmed.ascpjournals.org/content/39/3/134.short.

Marshall, M. (2009). Applying quality improvement approaches to health care. British Medical Journal, 339. Available at http://www.bmj.com/content/339/bmj.b3411.full.

McCulloch, P., Kreckler, S., New, S., Sheena, Y., Handa, A., & Catchpole, K. (2010). Effect of a “Lean” intervention to improve safety processes and outcomes on a surgical emergency unit. British Medical Journal, 2:(341). Available at http://www.ncbi.nlm.nih.gov/pubmed/21045024.

Ng, D., Vail, G., Thomas, S., & Schmidt, N. (2010). Applying the Lean principles of the Toyota Production System to reduce wait times in the emergency department. Canadian Journal of Emergency Medicine, 12:(1). Available at http://www.ncbi.nlm.nih.gov/pubmed/20078919.

Radnor, Z., & Walley, P. (2008). Learning to Walk Before We Try to Run: Adapting Lean for the Public Sector. Public Money and Management, 28:(1). Available at http://www.tandfonline.com/doi/abs/10.1111/j.1467-9302.2008.00613.x.

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