Many rumours, myths and misinformation surround Lean. Here, some of the most common questions are answered.

Isn't Lean just another cost-cutting exercise?

NO, is not a cost cutting exercise- it may lead to cost saving through better practice and saving waste but it does not start and end with Budgets.

Isn't Lean  just a way to cut jobs?

NO, Lean is not about cutting jobs- Improving a process or system is likely to lead to changes in responsibility and may even free up staff. These staff are usually re-deployed to assist the implementation of lean elsewhere with an organisation. Underutilising skilled people is one of the 8 wastes and should be avoided.

Lean is just another management fad isn't it?

NO, Lean has 100 years of evolution behind it, it has been constantly developed and adapted to new applications because it works. Its application in Healthcare is part of that evolution building on established tools and techniques. What makes Lean techniques work is they have inbuilt mechanisms to constantly re-assess best practice and change things for the better.

Is Lean just an easy quick fix?

NO- Lean is best described as a journey. Lean never stops as implementation of lean requires the constant review of processes. It never stands still and gives the tools to review and improve in a constant loop. Importantly it gives the tools to the people actually carrying out the task, in the case of Healthcare, the people providing the care will be empowered to change the systems to improve the service delivery.

Lean is very complicated isn't it?

Each of the Lean techniques are not complicated to learn in themselves. Things can get complicated when applying Lean techniques to large organisations and processes. Lean teaches people to understand very complicated processes in simple terms and spot the wastes and ways of improving. The drive to eliminate waste and constantly improve is not a complicated concept to understand.

We deal with life and death every day how will lean take account of this?

Safety in everything we do is at the core of Lean in healthcare. Lean techniques are used in petroleum, petrochemical, power generation industries. It is also used in manufacturing where potentially dangerous machinery is used every day and ensures adequate maintenance, risk assessment and ownership of equipment and process. By examining current processes in detail safety issues can be designed out of new processes and risk assessments made by appropriate healthcare professionals before any changes to current practices are made.

Lean is just a few fancy diagrams isn't it?

NO, Lean uses visual elements to include everyone in the process and by making information large and visible everyone can participate. The diagrams and tools are only part of Lean. The most important part of any Lean implementation is people.

What about 6 Sigma?

6 Sigma is another manufacturing philosophy routed in mass production. At its core is the elimination of defects and variation within processes. Its use within healthcare may seem at odds with treating each patient as an individual and the varied nature of healthcare work. That said, within 6 Sigma there enormously powerful statistical and problem solving techniques. Do not get hung up on improvement dogma, use whatever solves your problems to improve service delivery. In manufacturing an organisation would generally need a solid Lean foundation before moving onto 6 Sigma methodologies. Although it is entirely possible to use the techniques together. 

How does it all work?

In its broadest terms it provides a mirror to your organisation. It lets you see issues and problems and provides methods of solving those issues and problems in a collective and colaborative manner. People are empowered and supported by training to solve their own issues in a safe and productive way.

How will this effect my job?

Most people's jobs will change with a Lean implementation because everyone, at every level, gets involved in making decisions that affect the work they do. There are few healthcare examples yet but the following example would typical of what Lean has changed.

1976 line worker at a typical British car plant- Told what to do by supervisor (who knows best), told what to do and when to strike by the Union, has no authority, no power to stop the production line and makes a product that has an poor quality record, there is one suggestion box for the line that has never been used.

2003 Typical worker at Toyota/Landrover/Nissan/Ford in the UK has daily production and quality meetings, involved in design changes to the cars, participates in improvement meetings, is given regular on the job and off the job training, participates in exchange visits, is empowered to stop the line at any time for even the smallest quality issue, makes a world class product that they are rightly proud of.

The job of a production line worker in 2003 changed from that of 1976

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