Writing for the Institute of Medicine’s Learning Health System Commentary Series, Denver Health Chief Executive Officer Patricia A. Gabow, MD, discusses the value of using Lean processes to reduce costs and improve quality. “While Lean’s roots are embedded in the automobile industry and manufacturing, the philosophy and toolset fits with health care,” Gabow says. The philosophy, which is built on respect for people and continuous improvement, focuses on the removal of waste. “Toyota’s leaders have said that waste is disrespectful to humanity because it squanders scarce resources and that waste is disrespectful to individuals because it asks them to do work with no value,” Gabow writes. “In health care we could add that waste is disrespectful to our patients because it asks them to endure processes with no value.”

The results of this waste, according to Gabow, are lost resources that could go toward crucial needs such as education and infrastructure, diminishing numbers of high-quality health care workers who look to other fields that won’t stifle their talent with meaningless tasks and a disrespected patient population, asked to spend precious time sitting in waiting rooms and undergoing procedures that are not medically indicated.

So how do we get rid of waste? First, Gabow says, you must learn how to see it. “Take 8 or 10 people from a variety of areas into another part of your system and ask them to write down everything they see that they wouldn’t want to pay for as part of the process—it will be a long list,” she notes. Once you see waste, you can use Lean tools to remove it. “One of the appeals of Lean is that the tools are simple, allowing the entire workforce to be engaged,” says Gabow.

And Denver Health provides a clear example of the effectiveness of Lean, achieving the following successes since implementing Lean processes in 2006:

• $159 million in hard financial benefits
• top-10 ranking in the University Healthsystem Consortium Aggregate Accountability and Quality Score
• Shingo Bronze Medallion for Operational Excellence
• 78 percent of employees state that they understand how Lean helps the organization maintain its mission

Denver Health’s success can also be seen in its consistent recognition as one of the Most Wired hospitals by Hospitals & Health Networks magazine. For more on how Denver Health uses Lean processes to implement health information technology, read our innovations article,”Driving Quality With Lean HIT.”