Lean Six Sigma in Healthcare
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We have seen strong adoption of Lean in the healthcare industry, although they are still lacking behind many industries like semiconductor, automotive, aerospace and military/defense.
Virginia Mason Medical Center (Seattle) was one of the earliest and most cited adopters, developing the Virginia Mason Production System. They started applying Lean in 2002, adopting concepts like value stream mapping, standardized work, and 5S.
Institutions like ThedaCare (Wisconsin, USA) developed the ThedaCare Improvement System (TIS) in 2003, led by John Touissant. The National Health Service (NHS) in the United Kingdom (UK) supported Lean and Six Sigma programs in several trusts (such as Bolton NHS Foundation) in the mid-2000’s.
Want to learn how Lean methods have been implemented into healthcare?
Check out our free course, Applications of Lean in Healthcare
Early adopters focused on areas like emergency department flow, operating room efficiency and quality, waiting room time reduction, efficiency of electronic health records workflow and improvements to supply chain management.
As popularity rose, healthcare strongly adopted daily management systems (daily tiered huddles) to improve communication and problem escalation.
Cleveland Clinic (Ohio, USA) has been a model for continuous improvement since the mid-2010’s, applying lean into their operating rooms, labs and outpatient centers, and were able to reduced turnover times in operating rooms by 15–30%.
Other healthcare facilities that have had success include: Seattle Children’s Hospital, Saskatchewan Health Authority (Canada), Akron Children’s Hospital (Ohio, USA), Flinders Medical Centre (Adelaide, Australia), St. Boniface General Hospital (Winnipeg, Canada), Denver Health (Colorado, USA), Miami Children’s Hospital (Florida, USA) and many more.
UC San Diego Health has implemented Lean and Six Sigma methods starting in 2018 across multiple facilities in Southern California. They have delivered over 700 documented improvement projects that have positively impacted physician workloads, patient flow and wait times and overall patient experience. Since 2023, I have been teaching the Yellow Belt course remotely with UCSD Health.
Our support for Lean in healthcare
In 2019, I facilitated a multi-day kaizen event to improve the new hire on-boarding process at Central City Concern (a healthcare nonprofit in Portland, Oregon) so employees have everything they need on Day 1 of employment.
We have also conducted two lean assessments at dermatology clinics (2021 and 2025), identifying numerous opportunities to reduce waste, increase efficiency for doctors and medical staff, and improve the patient experience. I co-presented the 2021 assessment at the 2025 AAD conference in Orlando and I presented my experiences visiting both clinics and providing ideas for improvement at the 2025 Practical Symposium (see presentation below, or go to https://www.youtube.com/watch?v=j3aIlfVZLig)
Most recently, we helped facilitate a Lean training offsite for the nonprofit, American Red Cross for their blood laboratory leadership. It included a virtual gemba walk of the production facilities that separate blood donations into different blood components.
However, with all the success of Lean implementation (and much more is needed), there is still a gap in adoption of Six Sigma methods.
Patient harm and medical errors is still a major problem in healthcare, even after the landmark study conducted in 1999, called “To Err Is Human: Building a Safer Health System.” The report estimated that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That’s more than die from motor vehicle accidents, breast cancer, or AIDS combined, and that more people die annually from medication errors than from workplace injuries. These errors included surgical mistakes, medication errors, misdiagnoses, and failures in communication or system processes.
Our support for Six Sigma in healthcare
Here is how I have helped bring more statistical methods and Six Sigma techniques into healthcare over the years.
In 2004, while working at Rockwell Collins, I was asked to participate in a community grant project to reduce adverse events in the emergency department. One of the main reasons for emergency visits was due to medication issues for patients taking warfarin/Coumadin. The grant was focused on applying Lean and Six Sigma into healthcare. The grant led to the creation of a dedicated Coumadin clinic to help manage patients, online web-based INR test result tracking and patient management system (called INR Pro), and a Six Sigma project to improve INR test results between labs in the community. I’ve also managed the commercial software business since 2006, and provided customized statistical analysis on INR test data and time in therapeutic range (TTR %) for clinics and healthcare facilities all over the world.
As result of the grant, in 2008 we published Using Lean Six Sigma Tools to Compare INR Measurements from Different Laboratories within a Community – part of a 4-volume series of articles from AHRQ’s Advances in Patient Safety: New Directions and Alternative Approaches describing our work on the grant to improve patient outcomes and better manage patient visits and test results.
We have also contributed to the 2011 book “Using ISO 9001 in Healthcare: Applications for Quality Systems, Performance Improvement, Clinical Integration, and Accreditation” by James Levett MD and Robert Burney.
In 2018, I co-taught a 5-day Lean Six Sigma customized healthcare training at a national healthcare organization leadership team in Eastern Europe. The training was very hands-on, with a focus on working through actual data and numerous group discussions. It also included virtual consulting to help them create an improvement program with a deployment
In 2021-2022, I conducted a 4-week Six Sigma Black Belt training for those working at a COVID testing facility near Cincinnati (Ohio, USA).
In 2023, I became involved in another grant initiative to increase the use of FMEA and risk assessments in healthcare to identify co-morbidity risks for patients within surgical procedures.
The use of Six Sigma is greatly lacking in healthcare today. We can help!
If you would like help integrating more statistical methods and analysis into your healthcare organization, check out our Guided Lean Six Sigma Certification Healthcare program, or get started with our free course, Applications of Lean in Healthcare.
Want to learn how Lean methods have been implemented into healthcare?
Check out our free course, Applications of Lean in Healthcare
