Bringing the Business Model into Clinical Practice: The Lean Approach


Published: 09 May 2015

The concept of lean management has been used successfully throughout Japanese society, particularly by car manufacturing companies like Toyota. There are many who believe that the use of these same principles can dramatically transform the landscape of healthcare delivery. The concept of lean healthcare centres on eliminating waste and using less to create more. As the cost of many healthcare systems around the world continue to rise, the patient outcomes remain disproportionately poor. A simple observation of this situation allows one to see that money is not an issue, the main concern is how the money is used. Imagine watering your garden with a leaky water hose. Regardless of how much water you funnel through the hose, there will be a lot of waste.

Lean Healthcare

A potential model for lean healthcare.

A potential model for lean healthcare.

The lean approach states that for a process to be ideal each step must be important, proficient, easily accessible, and flexible. The Toyota lean principles identify seven areas of potential waste. These are: overproduction, waiting, transporting, processing, inventory, motion, and correction. This article will investigate the merits of reducing waste by controlling expenditures in clinical practice.


The Toyota Lean approach in clinical practice means including only processes that are successful. For a private hospital, for example, underperforming departments often create a significant financial burden on the hospital. By simply removing these services we free professionals to contribute to the other parts of the hospital, free beds up, and can reduce the patient load of related departments. The hospital can now focus on using these resources in order to provide quality, effective care to the remaining patients.

Of course, it goes without saying that healthcare is not a business alone and that some services must be provided regardless of their commercial viability.

Flexibility in Staff Assignment

Rather than having clinical staff such as nurses assigned to a specific department, some flexibility could be created if they were to rotate on an as-needed basis. This calls for acceptance by clinical staff, as some may resist such demands. It also moves away from the mindset of working for a department. Instead, the focus becomes the patients and the healthcare team does everything it takes to ensure that every part of the process creates value for those in their care.

Daily Administrative Checks

Implementing the lean management concept by cutting down on the waiting or movement of people will significantly reduce financial wastage. By ensuring that the clinical team provide reasonable daily justification for each admitted patient, significant waste can be decreased. This may also decrease the chance of patients developing hospital-acquired infections, which can be costly and may consume the hospital’s revenues. It could also increase the capacity for admitting new patients since the patient flow is no longer impeded.


It has always been the objective of the healthcare system to provide value to our patients. The Toyota lean principles have been applied to many industries over the past few decades and have revolutionised the way those industries operate. However, to be successful in introducing these concepts in a clinical environment, the creation of a clinical culture where all staff are committed and flexible will be essential. If applied properly, this management approach could significantly improve output, reduce expenditure, increase value, and provide well-timed delivery of healthcare services to our community. After all, isn’t this the goal of our healthcare system?