Posted tagged ‘Lean’

How Denver Health Spectacularly Improved Their Operations

February 12, 2012

Patricia A. Gabow, M.D., CEO of Denver Health and Hospital Authority, has spectacularly  improved Denver’s public hospital and busiest trauma center by asking the right questions and implementing Lean.

In a blog post by Matthew Weinstock at Hospitals and Health Network Gabow says, “I was really becoming frustrated that we were doing things pretty much the same way as when I was an intern 40 years earlier,” Gabow says. “I started to ask myself, ‘Is there any other industry that has been so stuck in time and been successful?’ I talked to a service line director about it and he suggested that we did things the same way because it worked. ‘Give me a break. We can do better.’ I told him.”

So, around 2004, Denver Health applied for and got a grant to see if there was indeed a better way. They built an advisory panel and brought in experts from other leading industries — Microsoft, Siemens, and FedEx. Gabow held upwards of 60 focus groups with Denver Health employees, asking two key questions:

“What are the things that keep you from being efficient?”


“what do you see happening to patients that you think is wrong?”

After a year of studying operations, leadership determined that there wasn’t “one magic bullet,” Gabow says. Instead, they realized that they needed a series of “linked endeavors.” That’s when they turned to Lean management. Gabow says Lean is appealing because it is based on respect and innovation. Secondly, the tools used in Lean are intuitive and relatively easy to teach and learn. Implementing Lean management  in 2005, has resulted in the following achievements:

  • Trained more than 250 employees as black belts in Lean
  • Completed more than 400 rapid-improvement projects, resulting in that $135 million financial benefit due to performance improvements
  • Last year alone, the hospital saw $46 million in financial benefits from Lean projects.
  •  Impressively, Denver Health has achieved the high quality marks and boost to the bottom line without reducing the workforce.
  • #1 — ranking in patient survival among the nation’s academic medical centers
  • 100 percent — number of patients receiving antibiotics in pre-op
  • 80 percent and $1.75 million — drop in blood clots among hospitalized patients and the savings as a result of reduced complications
  •  An impressive 60 percent drop in Denver Health’s observed to expected mortality. “That meant that last year, 250 people walked out of our hospital alive who would have been expected to die at another academic health center.” stated Galbow.

As CEO of Denver Health, Gabow’s leadership and willingness to ask questions has had a huge impact at the hospital. What do you think of the approach utilized by Gabow at Denver Health?

Bringing Lean Management To New York State

January 8, 2012

In January of 2011 shortly after taking office as Governor, Andrew Cuomo signed an executive order creating the Spending and Government Efficiency (SAGE) Commission. The purpose of SAGE is to modernize and rightsize government to make it more efficient, effective and accountable.

On December 15, 2011, the SAGE Commission met and approved some interesting recommendations. As a supporter of utilizing Lean Management in government, I was pleased to see that the Commission has recommended the following:

Establish an Office of Lean Management for New York State – Hire two Lean Management professionals to develop Lean capabilities across state government by conducting training sessions for agency managers.

First pioneered at Toyota over 50 years ago, Lean is a philosophy and long proven approach for organizations of any size or type to continuously improve. With Lean there is a focus on eliminating waste, improving productivity, and achieving sustained continual improvement in an organization. Lean is built on the philosophy that small, incremental changes routinely applied and sustained over a long period result in significant improvements overall.

Lean seeks to foster a culture where employees are empowered to identify and solve problems. Lean organizations empower their members on the front lines by teaching them how to identify ‘waste’, or anything that doesn’t add value to the process.

Eight Common Wastes that are often roadblocks to efficiency:

1. Overproducing: unneeded reports, doing work not requested.

2. Waiting: time for approval cycles, waiting for information or decisions.

3. Transportation: unnecessary movement of reports, storage of documents.

4. Inventory: backlog of work, (permits, plan approvals) excess materials/info, obsolete databases/files.

5. Unnecessary motions: trips to printer and copier, unnecessary movement to find files and supplies, travel to meetings.

6. Processing waste: spending time on unnecessary processes that do not add value to the customer.

7. Defects: data errors, missing info, errors in documents, wasted effort on inspection or re-doing work that was already done.

8. Unused human potential: not fully utilizing employee problem solving skills to add value to the customer or the company.

Every program/department in government can be improved by addressing the eight items above. It is great to see New York under Governor Cuomo’s leadership moving to implement Lean as a way to improve the performance of government. Three New York agencies are already utilizing Lean to improve their operations:

Office of Alcoholism and Substance Abuse Services – Reduced the amount of time it takes to complete their Request For Proposal  process by 53% (146 days).

New York State Office for People with Developmental Disabilities –  It currently takes the agency 300+ days to do a State Auspice Transfer. By utilizing Lean the agency projects that it can reduce the time to 120 days.

Department of Environmental Conservation –  It currently takes the DEC 250+ days to issue a New Air Quality Permit. By utilizing Lean the agency projects that such permits can be issued within 121 days max.

For more information on how Lean is being used in government check out the following links:

What do you think about utilizing Lean as a way to improve government performance?