Lean in Health Care
The Iowa Healthcare Collaborative (IHC), with direction from the Iowa Business Council and in cooperation with health care providers across the state, has developed the following Lean in Health Care toolkit. The toolkit is a compilation of resources to support incorporation of Lean process improvement tools into health facilities across Iowa.
We would like to thank those individuals and organizations who have shared their materials and who have agreed to serve as mentors. Please contact IHC at 515-283-9330 if your organization would like to contribute materials to this toolkit.
Case for Change
Project Description
Tool Kit
Iowa Health Care Contacts
| Spencer Hospital Doug Doorn President and CEO ddoorn@spencerhospital.org 712-264-6111 |
Mercy Medical Center Cedar Rapids Kimberlee Haskins Director of Organizational Development khaskins@mercycare.org 319-369-4557 |
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| University of Iowa Healthcare Sabi Singh Assistant Vice Present for Operations, Excellence, Quality & Safety sabi-singh@uiowa.edu 319-353-7202 |
Iowa Health - Des Moines Gayle Culbertson culbergd@ihs.org 515-241-6859 |
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| Skiff Medical Center – Newton Bob Campbell Director of Quality Management & Risk Management bcampbell@skiffmed.com 641-791-4347 |
Jennie Edmundson Hospital Council Bluffs Steven Baumert CEO & President stevebaumert@nmhs.org 712-396-6239 |
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| St. Luke's Hospital Dean Bliss Director of Lean Improvements blissd2@crstlukes.com 319-368-5724 |
Pella Regional Health Center – Pella Sarah Cottington, BS, RHIT Performance Improvement & Service Excellence Coordinator scottington@pellahealth.org 641-628-6683 |
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| Mercy Medical Center Dan Varnum VP of Performance Improvement dvarnum@mercydesmoines.org 515-643-8746 |
Mahaska County Health Partnership OPEN Director of Quality Management scottington@mahaskahospital.com 641-672-3285 |
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| Mercy Medical Center Cedar Rapids Kathy Krusie VP of Human Resources KKrusie@mercycare.org 319-398-6451 |
Jefferson County Hospital – Fairfield Staci Worley Education Coordinator SWorley@jchospital.org 641-469-4232 |
Iowa Industry Contacts
| Alliant Energy | ||
| Ron Hellweg Project Manager Office Deployment Leader RonaldHellweg@alliantenergy.com 319-786-4668 |
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| John Deere Public Affairs | ||
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Mara Sovey State Public Affairs Manager SoveyMaraL@JohnDeere.com 515-267-4432 |
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| Pella Corporation | ||
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Gina Singer GMSinger@Pella.com 641-621-1000 |
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| Rockwell-Collins | ||
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Tom Hobson trhobson@rockwellcollinis.com 319-295-1000 |
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| Vermeer Manufacturing Co | ||
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Louis Norton Continuous Improvement Manager – Business Process lnorton@vermeermfg.com 641-621-7715 |
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Iowa Government Contact
| Iowa Department of Natural Resources Teresa Hay McMahon Executive Officer 515-281-0110 |
Iowa Community College Contacts
The reVIEW© training program, originating from Lean Healthcare West, "teaches simple, proven tools for Lean implementation that are immediately practiced on real issues in your workplace." The following individuals have been trained to bring the reVIEW© program to organizations.
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For general information contact: Collette Saylor Executive Director 515-964-6267 casaylor@dmacc.edu www.iacct.com www.leanhealthcarewest.com |
Lean Consultants
| Breakthrough Management Group 1921 Corporate Center Circle Longmont , CO 80501 303-827-0010 1-800-46-SIGMA moreinfo@bmgi.com www.bmgi.com |
Lean Advisors, Inc. 613-821-4545 506-849-2668 www.leanadvisors.com |
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| Gemba Research, LLC 13000 Beverly Park Rd. Suite B Mukilteo, Washington 98275 888-464-3622 425-356-3150 info@gemba.com www.gemba.com |
Simpler 2814 Oak Meadow Drive Suite 201 Ottumwa, IA 52501 1-888-532-6888 carrolld@simpler.com www.simpler.com |
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| Guidon Performance Solutions 2550 N Thunderbird Circle Suite 317 Mesa, AZ 85281 866-986-4414 www.guidonps.com |
TBM Consulting Group Corporate Office 4400 Ben Franklin Blvd. Durham, NC 27704 1-800-438-5535 tbm@tbmcg.com www.tbmcg.com |
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| HPK Group, LLC PO Box 1974 Windemere, FL 34786-1974 407-808-4785 www.hpkgroupllc.com |
ValuMetrix Services 1001 US Route 202 Raritan, NJ 08869-0606 800-523-6911 ext. 8316 or ext 3821 valumetrix@ocdus.jnj.com www.valumetrixservices.com |
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| Kenagy & Associates 625 Mt. Auburn St. Cambridge, MA 02138 617-491-1476 query@kenagyassociates.com www.kenagyassociates.com |
Resources
Articles
New Additions
The following article features several members of the IHC 2008 Lean Steering Committee:
- "Lean in Healthcare." (Website) Elizabeth Saunders. IAbiz Online, February 5, 2008.
Other new additions:
- "Creating an Environment for Caring Using Lean Principles of the Virginia Mason Production System." (PDF 2.06 MB) Dana L. Nelson-Peterson & Carol J. Leppa. The Journal of Nursing Administration, Volume 37 Number 6 2007.
- "Dentist Drills Down to the Root Causes of Office Waste." (PDF 536 KB) Lean Enterprise Institute.
- "Mistake-Proofing the Design of Health Care Processes." (PDF 1.5 MB) John Grout. Agency for Healthcare Research and Quality, Publication No. 07-0020 May 2007.
- "Pulling Lean Through a Hospital." (PDF 1.7 MB) George Taninecz. Lean Enterprise Institute.
Old Articles:
- "Apply 'Lean' Principles in the Health-Care Industry." (Website) Donna Daniel. Puget Sound Business Journal, October 28, 2005.
- "Decoding the DNA of the Toyota Production System." (Website) Steven Spear & H. Kent Bowen. Harvard Business Review, September-October 1999.
- "Fixing Healthcare from the Inside, Today." (Website) Steven Spear. Harvard Business Review, September 2005.
- "Going Lean in Health Care." (PDF 137KB) Institute for Healthcare Improvement, 2005.
- "Lean Sigma – Will It Work for Healthcare?" (PDF 341KB) James Bahensky, Janet Roe, & Romy Bolton. Journal of Healthcare Infection Management, Winter 2005. 19(1): 39-44.
- "Lean Thinking for the NHS" (PDF 471KB) Daniel Jones and Alan Mitchell. NHS Confederation, 2006.
- "Learning to Lead at Toyota." (Website) Steven Spear. Harvard Business Review, May 1, 2004.
- "Maximizing Hospital Outcomes with Tips from Toyota: Using Less to Do More." (Website) Gary S. Kaplan. Physician's Weekly, October 3, 2005.
- "Power of Lean in the Laboratory: A Clinical Application." (PDF 69KB) Jennifer Blaha & MariJane White. GE Healthcare White Paper, 2006.
- "Reducing Waste and Errors: Piloting Lean Principles at Intermountain Healthcare." (PDF 558KB) Cindy Jimmerson, Dorothy Weber & Durward K. Sobek II. Journal on Quality and Patient Safety. 31(5): May 2005.
Books
New Books - Additions
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Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction |
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A Lean Guide to Transforming Healthcare: How to Implement Lean Principles in Hospitals, Medical Offices, Clinics, and Other Healthcare Organizations |
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The Pittsburgh Way to Efficient Healthcare: Improving Patient Care Using Toyota Based Methods |
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Winning Score: How to Design and Implement Organizational Scorecards |
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5S for Service Organizations and Offices: A Lean Look at Improvements |
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Lean For Dummies |
Old Books
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A3 Problem Solving for Healthcare: A Practical Method for Eliminating Waste |
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Becoming Lean: Inside Stories of U.S. Manufacturers |
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Leading Change |
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The Lean Healthcare Pocket Guide |
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Lean - Six Sigma for Healthcare: A Senior Leader Guide to Improving Cost and Throughput |
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Lean Six Sigma for Service: How to Use Lean Speed and Six Sigma Quality to Improve Services and Transactions |
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Lean Six Sigma: Combining Six Sigma Quality with Lean Speed |
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Lean Solutions: How Companies and Customers Can Create Value and Wealth Together |
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Learning to See: Version 1.3 |
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Lean Thinking: Banish Waste and Create Wealth in Your Corporation |
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The Machine that Changed the World: The Story of Lean Production |
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Stop Rising Healthcare Costs Using Toyota Lean Production Methods: 38 Steps for Improvement |
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The Toyota Way: 14 Management Principles from the World's Greatest Manufacturer |
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The Toyota Way Fieldbook |
Presentations
- Dean Bliss, St. Luke's Hospital, Cedar Rapids, IA (PDF 777KB)
Lean Overview
- Sarah Pavelka, Quality Management/Organizational Development Specialist (PDF 1.1MB)
Lean Paradigm- 5S tool- used to develop the most efficient workspace and eliminate waste in day-to-day operations.
View and Print Speaker Handouts from the 2007 Annual Lean Conference
- Lean Basics (PDF 370KB)
Dean Bliss, Director of Lean Improvement, St. Luke's Hospital, Cedar Rapids
This presentation provides a basic understanding of the Lean methodology, including terminology and acronyms.
- Reinventing Health Care: Improving Quality as a Determinant for Reducing Cost (PDF 1.94MB)
Karen Wolk Feinstein, PhD, President/CEO, Jewish Healthcare Foundation and Pitts burgh Regional Health Initiative, Pittsburgh, PA
This presentation examines the way in which quality improvement leads to cost reduction and the innovative way in which health care institutions in Pennsylvania are using process engineering to achieve improvements.
- Non Healthcare Approach to Lean (PDF 27KB)
Teresa Hay McMahon, Performance Results Director, Iowa Department of Management, Des Moines
Jeff Ruiter, Director of Demand Distribution, EDS, Des Moines
These two presentations describe how Lean methodology has been successful in non-health care environments in reducing costs, increasing productivity and achieving greater customer and employee satisfaction.
- Creating a Culture of Improvement at Mercy Medical Center-Des Moines (PDF 889KB)
Dan Varnum, MBA, Vice President of Performance Improvement, Mercy Medical Center – Des Moines
This presentation will walk you through how Mercy Medical Center – Des Moines had continued to develop its culture of process improvement, and share successes and lessons learned.
- Improving Processes to Decrease Cost and Improve Service (PDF 82KB)
Jay Christensen, Administrator; and Les Martin, Director of Continuous Improvement, Mahaska Health Partnership, Oskaloosa
This presentation illustrates how the Mahaska Health Partnership decreased costs and improved customer service through simple organizational changes.
Lean Overview
Lean Paradigm- 5S tool- used to develop the most efficient workspace and eliminate waste in day-to-day operations.
Dean Bliss, Director of Lean Improvement, St. Luke's Hospital, Cedar Rapids
This presentation provides a basic understanding of the Lean methodology, including terminology and acronyms.
Karen Wolk Feinstein, PhD, President/CEO, Jewish Healthcare Foundation and Pitts burgh Regional Health Initiative, Pittsburgh, PA
This presentation examines the way in which quality improvement leads to cost reduction and the innovative way in which health care institutions in Pennsylvania are using process engineering to achieve improvements.
Teresa Hay McMahon, Performance Results Director, Iowa Department of Management, Des Moines
Jeff Ruiter, Director of Demand Distribution, EDS, Des Moines
These two presentations describe how Lean methodology has been successful in non-health care environments in reducing costs, increasing productivity and achieving greater customer and employee satisfaction.
Dan Varnum, MBA, Vice President of Performance Improvement, Mercy Medical Center – Des Moines
This presentation will walk you through how Mercy Medical Center – Des Moines had continued to develop its culture of process improvement, and share successes and lessons learned.
Jay Christensen, Administrator; and Les Martin, Director of Continuous Improvement, Mahaska Health Partnership, Oskaloosa
This presentation illustrates how the Mahaska Health Partnership decreased costs and improved customer service through simple organizational changes.
Websites
- American Society for Quality is a membership organization devoted to quality. "We have the knowledge, tools, expertise and resources to inspire you and your organization."
- Association for Manufacturing Excellence is a not-for-profit organization dedicated to cultivating understanding, analysis and exchange of productivity methods and their successful application in the pursuit of excellence.
- Gemba Research produced a useful Lean Manufacturing Toolkit.
- I Six Sigma is a site that provides information on Six Sigma process improvement.
- Lean Blog is a blog about Lean in factories, hospitals, and the world around us.
- Lean Enterprise Academy is a source of Lean information for those in the United Kingdom.
- Lean Enterprise Institute is a nonprofit education and research organization founded in 1997 to promote and advance the principles of lean thinking in every aspect of business and across a wide range of industries.
- Lean Healthcare West is a group of experienced healthcare professionals that serve as implementation consultants for Lean in health care.
- Productivity Press is a publisher of Lean improvement books.
- Quality Press is a publisher of books on subjects such as quality improvement and Lean.
- Star Thrower provides innovative training materials.
- Superfactory offers resources supporting lean manufacturing and lean enterprise best practices.
- University of Michigan College of Engineering Center for Professional Development offers a one-week Lean Healthcare Certificate Program.
Success Stories
Below are Process Improvement Success Stories from St. Luke's Hospital – Cedar Rapids, Mercy Medical Centers in Cedar Rapids and Des Moines, and the University of Iowa Hospitals and Clinics.
Spencer Hospital – Spencer
St. Luke's – Cedar Rapids
St. Luke's Hospital – Cedar Rapids
Mercy Medical Center – Cedar Rapids
Mercy Medical Center – Des Moines
University of Iowa Hospitals and Clinics
Allen Hospital - Waterloo
View the agenda (PDF 195KB) from the 2006 IHC Lean in Health Care Conference.
IHC would like to thank the Lean Steering Committee:
| Vicki Baum | Indian Hills Community College |
| Dean Bliss | St. Luke's Hospital, Cedar Rapids |
| Doug Doorn | Spencer Hospital |
| Tom Evans, MD | Iowa Healthcare Collaborative |
| Kimberlee Haskins | Mercy Medical Center, Cedar Rapids |
| Jeff Jutting | Mercy Medical Center, Des Moines |
| Kyla Kiester | Iowa Healthcare Collaborative |
| Perry Meyer | Iowa Hospital Association |
| Vince Newendorp | Vermeer Manufacturing, Pella |
| Sarah Pavelka | Iowa Quality Center, Marion |
| Mike Rohlf | Iowa Department of Management |
| Sabi Singh | University of Iowa Hospitals & Clinics, Iowa City |





















