Applying Lean Principles In Healthcare


The healthcare sector in the United States continues to experience numerous deficiencies that demand a comprehensive approach to their resolution. To alleviate a portion of these factors, the five principles of Lean, which require a product to be value-efficient, streamlined, customer-oriented, and of the highest possible quality (Ward, 2019). Nurses, who are directly responsible for providing care, are commonly tasked with patient interactions. This notion puts them on the frontline of any medical facility and makes them the essential link between customers and the services that a hospital offers. As of now, the complexity of this profession, in combination with inadequate goals and time limits, puts patients at a disadvantage (Harvey et al., 2018). In order to improve this part of healthcare, it is crucial to make significant changes to nurses’ current workload. In this paper, the application of five principles of Lean in work performed by nursing personnel will be proposed.


Since the five principles of Lean commonly refer to the needs of customers, to which nurses are typically appointed, their focus must be on the maximization of the value transferred to patients. The process of nursing is a service that creates its worth in the form of efficient care that helps one to achieve a desired level of well-being. It possesses many components, yet they all rely on a single resource that nurses have – time. Therefore, nursing can become leaner by reimagining wasteful or redundant activities and unoptimized work schedules.

There are numerous adverse aspects that slow down this process. Insufficient experience, in conjunction with high stress due to the need to perform multiple tasks within a short period, often causes workers in this industry to burn out and leave their profession (Harvey et al., 2018). A hospital environment is governed by many unpredictable factors and events, making nursing a highly challenging process to execute through Lean principles. However, there are parts of this set of activities that can be influenced by hospital-wide policies and changes in a facility’s organizational culture.


There is a necessity to alleviate the burden that nurses experience in their workplaces. The first principle of value requires nursing workers to contribute to their patient’s health with the highest possible cost-efficiency. Employees who are able to meet their customers’ requirements in a timely fashion require a different approach to management, which will include a semi-autonomous task appointment and a shift toward transformative leadership (Pyzdek, 2021). Relative independence can play a major positive factor in nurses’ ability to cater to patients’ needs.

Healthcare services are obliged to work toward the well-being of patients, making it critical to focus on eliminating objectives that do not benefit customers. The second principle requires a facility to determine such issues, which can be achieved via brainstorming sessions among engaged employees who can vote for the most wasteful tasks. The third principle requires a new approach to be linear and well-understood by the involved individuals (Ward, 2019). For the next stage, a course on Lean methods of work ethics must be conducted among personnel, which must include industry-specific goals. Nurses have the responsibility to respond to potentially life-threatening situations within a short period, making it vital to account for such disruptions when creating an intervention. A task of this magnitude requires a new leadership that will guide them toward making decisions autonomously.

The next Lean principle stems from the newly established workflow and requires leaders to ensure that all patients are given sufficient attention despite the removal of care ratios. While nurses will be encouraged to make decisions individually, work must not become more or less intense than before this intervention (Harvey et al., 2018). To cover the final principle, this work culture must be perfected through a constant search for improvements and strict adherence to the proposed strategy. A list of tasks for each nurse has to be internalized through meticulous preparation of staff for a drastic change in their schedules. Moreover, their new workload must reflect the needs of customers with greater efficiency. Therefore, an electronic framework for a hospital must be introduced that will give each nurse greater control of their schedule and allow them to reflect on their set of abilities and selected tasks.

Accepting the Proposal

Any significant change has a chance of being dismissed due to its perceived complexity, making it vital to provide a clear explanation of its benefits versus potential downsides. Thankfully, the five principles of Lean have been applied extensively throughout many industries, including healthcare, with examples of both failures and successes. Therefore, a proposal for such a system will rely on using evidence from other hospitals to determine its applicability. A case study can provide vital statistics regarding subjective experiences of nurses whose workloads were modified through Lean interventions, reveals possible downsides, such as fragmentation of activities, and examine value-quality relationship (Udod et al., 2020). Showing senior managers this data can alleviate the potential flaws in a new scheduling system and complement it with additional knowledge from professional leaders.

Barriers to the Implementation

It is essential to determine what factors may prevent the proposed shift in the work environment of nurses from being impactful. Implementing a Lean management framework requires extensive training of its participants, which implies high financial costs and the loss of potential work time (Udod et al., 2020). Senior leaders may recognize this need and refuse the proposal due to its possible failure to provide the same value that will be spent on courses to a hospital. Moreover, a situation may require too many variables to be accommodated into the new schedule system, turning it into an issue that will slow down a hospital’s operations. This issue may lead to nurses creating openings in their schedules at times when their assistance is required. Thus, many factors may cause a Lean approach to fail in a hospital environment. For example, nurses may struggle to accommodate all patients’ needs and avoid essential yet grueling tasks, creating a fragmented time management framework (Udod et al., 2020). They can be avoided with proper policies and extensive application of practices that helped other medical institutions to implement a time-efficient scheduling system successfully.


In conclusion, it is essential for healthcare facilities to adopt the five principles of Lean and transfer their benefits to customers, as the current work environment has a detrimental impact on the quality of care. Since customers often perceive a hospital’s efficiency through nursing personnel, improving this process can achieve a significant increase in their work’s value. Autonomy and transformative leadership are efficient tools that can help a hospital establish a proper Lean culture by giving workers an opportunity to align their activities with the actual needs of patients. Despite a possibility of failure, this approach has been tested and successfully implemented in the healthcare industry.


Harvey, C. L., Baret, C., Rochefort, C. M., Meyer, A., Ausserhofer, D., Ciutene, R., & Schubert, M. (2018). Discursive practice – lean thinking, nurses’ responsibilities and the cost to care. Journal of Health Organization and Management, 32(6), 762-778. Web.

Pyzdek, T. (2021). The lean healthcare handbook: A complete guide to creating healthcare workplaces (2nd ed.). Springer Nature.

Udod, S. A., Duchscher, J. B., Goodridge, D., Rotter, T., McGrath, P., & Hewitt, A. D. (2020). Nurse managers implementing the lean management system: A qualitative study in Western Canada. Journal of Nursing Management, 28(2), 221-228. Web.

Ward, A. (2019). Lean design in healthcare: A journey to improve quality and process of care. Taylor & Francis.