Lean Basics  


Teiaundrea Ransom
Member Admin
Joined: 2 years ago
Posts: 8
24/10/2018 11:16 am  


It is that time again… time to get lean! Last time we touched on understanding what is lean and how this can benefit healthcare organizations. For this blog, we will focus more on understanding what it means to create a lean culture and leadership’s role in lean. There are two things that must happen to succeed at becoming a lean organization:

  • Leadership: Those at the very top must lead this change. Strong commitment and inspiring leadership from senior leaders is essential to the success! The leaders must be aligned in the vision and understanding of lean.
  • Culture: A lean culture is the backdrop against which lean tools and techniques are implemented. A culture must be created where all employees feel a part of the process for continuous improvement.

Let’s take a moment to take a look at the differences between a traditional culture and a lean culture. It truly is a shift in thinking about how teams work together and how leaders lead.

Traditional Culture

Lean Culture

Function Silos

Interdisciplinary teams

Managers direct

Managers teach/enable

Benchmark to justify not improving: “just as good”

Seek the ultimate performance, the absence of waste

Blame people

Root cause analysis

Rewards: individual

Rewards: group sharing

Supplier is enemy

Supplier is ally

Guard information

Share information

Volume lowers cost

Removing waste lowers cost

Internal focus

Customer focus

Expert driven

Process driven


To have a lean culture, it must start with leadership and the behaviors that leadership exhibits. To succeed, the commitment to lean must start at the very top of the organization. As a result, it is important to understand leadership’s role in lean.

  1. Know how the business serves the customer
    • Understand what customers want, need, and what will delight them
    • Always be thinking of how to bring more value to the customer
  2. Build ability in the people
    • Encourage problem solving through root cause analysis
    • Ask open-ended, probing questions
    • Leadership should not solve the problems but lead the teams to solve the problems. People believe more in a solution if they help create and implement the solution.
  3. Be engaged and on the floor (“Go See Management)


Before you comment on the state of an operation, you must “go see” for yourself. Do not rely on what others tell you. All people see through a different set of eyes, have different priorities, and different perspectives.

  • A leader should spend a significant portion of their time “in the gemba” (where the work is being done)
  • Leaders must observe processes themselves and draw conclusions based on their observations
  • Leaders talk to the people actually doing the work…. remember, they are the people who truly know what is going on and where problems exist.


  1. Change the mentality from problem-hiding to problem-solving
    • All actions should revolve around planning and problem-solving
    • It should be assumed that there will be problems, that everything will not go according to plan
    • No problem is problem
    • For the system to work, problems must be exposed and dealt with forthrightly
    • Hiding problems will undermine the system
    • Leaders should not start by asking who but should instead ask why. Don’t jump to conclusions or solutions… first try to size up the situation and then ask “Why?”
  2. Show a continuous improvement mindset
    • Challenge the status quo
    • Understand that there is always room for improvement and nothing is perfect
    • Understand that the customer’s needs change… what may delight the customer today may not be what is needed tomorrow
    • Put in the time to continue learning lean and to continue improving processes (improve upon improvements): Kaizen Events, 5 S’s, Visual Management
  3. Create a culture to sustain improvement
  • Identify and encourage lean behaviors
  • Find the lessons in every failure. Remember, blame does not foster improvement
  • Respect and improve standards… improve upon improvements


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