This document discusses how Lean is sometimes seen as mean in healthcare but argues that it does not have to be. It provides four reasons why Lean is sometimes seen as mean: 1) Focusing on cutting staff to fit budgets instead of empowering existing staff, 2) Not helping employees and mandating tools without explanation, 3) Blaming others instead of taking responsibility, 4) Mandating tools without explaining their benefits. However, the document argues that real Lean is sustainable and benefits patients through reduced wait times and errors, benefits employees by reducing waste and frustration, and benefits organizations by strengthening them long-term and improving quality while reducing costs.

1. Lean is Not Mean in Healthcare
Mark Graban
(From 2007)

2. Why LEAN Works in Healthcare
• LEAN is not a list of things to do that applies
only to factories
• LEAN is a philosophy of management that
applies to any system
• LEAN rallies people around goals we can all
agree on:
– Patients and Employees
© Mark Graban & Constancy, Inc. 2007-
2014
www.MarkGraban.com

3. Why is LEAN sometimes
seen as MEAN?
© Mark Graban & Constancy, Inc. 2007-
2014
www.MarkGraban.com

4. Reason 1: Focus on Cutting Heads
• MEAN: Announcing staff cuts to fit budget
numbers, then making everyone figure out
how to get by with fewer people
• MEAN: Having lean success and then laying
off people from that area
© Mark Graban & Constancy, Inc. 2007-
2014
www.MarkGraban.com

5. Reason 2: Not Helping Employees
• MEAN: Mandating an isolated lean tool
because management thinks it will help
– “We’re doing 5S, so you need to put tape around
everything”
• MEAN: Not understanding that lean is more
than just a tool or tools
© Mark Graban & Constancy, Inc. 2007-
2014
www.MarkGraban.com

6. Reason 3: It’s You, Not Us
• MEAN: Pointing the finger at everyone else:
– Employees, suppliers, partners, customers
– “We’re OK, but YOU need to get lean”
© Mark Graban & Constancy, Inc. 2007-
2014
www.MarkGraban.com

7. Reason 4: Mandating Lean
• MEAN: Telling employees they need to use
some lean tools without explaining:
– Why the tools will help
– How lean tools fit into an overall lean approach
– How using the tools will help employees and
patients
– How lean fits into the long-term vision
© Mark Graban & Constancy, Inc. 2007-
2014
www.MarkGraban.com

8. LEAN: Mean or Not
• You can be “mean” and drive out waste today
• “Real Lean” is not mean
– Much more sustainable in the long term
© Mark Graban & Constancy, Inc. 2007-
2014
www.MarkGraban.com

9. LEAN: Mean or Not
• MEAN
– Telling/ordering people
to do lean so they resent
it
– Lean methods add an
additional “burden” to
employees
• NOT MEAN
– Explaining why lean
benefits them so they
want to do it
– Lean methods reduce
waste and free up
employee time
© Mark Graban & Constancy, Inc. 2007-
2014
www.MarkGraban.com

10. Reasons Why LEAN is Not
Really MEAN

11. LEAN is Good For the Patient
• Improvements in Clinical Quality
– Fewer mistakes and errors
– More time with providers
• Reduced Waiting Time
– Fewer delays, less waiting
– Lean values patient time almost as much as
MD time
© Mark Graban & Constancy, Inc. 2007-
2014
www.MarkGraban.com

12. LEAN is Good For the Employees
• Reduced waste
• Reduced walking
• Reduced frustration
• Solving the “everyday problems”
• More time available for value-added work
– Patient care
– Lab testing working
© Mark Graban & Constancy, Inc. 2007-
2014
www.MarkGraban.com

13. LEAN is Good For the Organization
• LEAN is about:
– Building a strong organization in the long term
– Reducing costs through eliminating waste
– Driving revenue growth through
• Improved quality (clinical and patient satisfaction)
• Increased capacity without huge investment
– Attracting and keeping great employees
© Mark Graban & Constancy, Inc. 2007-
2014
www.MarkGraban.com