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Lean

The Lean method was developed in the mid-20th century to simplify processes and remove any steps that do not add value to the customer. By removing “waste,” practices can make processes streamlined, more efficient, and more reliable. While it may be most effective to work with experts in Lean, some of its core concepts can be used by anyone with an interest in improving quality. There are multiple levels of Lean expertise, ranging from master black belts who can train others in Lean to black belts who can function independently and use any of the tools in quality improvement to green belts who can provide support in improvement efforts. There are many ways to develop these skills, such as in-person, project-based, organizationally supported, or online options.

Tools You Can Use

Additional tools that may be useful in quality improvement and practice transformation include:



An example of a Lean tool used in health care is the 5S, which creates effective workplace organization and standardized procedures to improve safety, quality, productivity, and employee attitudes.

5S—With 5S, every item in an exam room, office, or practice has its place. The most efficient placement of items (e.g., patient education materials, monofilaments, flowsheets, product samples) can be identified, and clinicians will reduce time/burden in finding them. Ideally, the placement of items is standardized across each setting. The 5Ss are:

  • Sort (eliminate what is not needed)
  • Set in order (organize remaining items)
  • Shine (clean and inspect work area)
  • Standardize (write standards for above)
  • Sustain (regularly apply the standards)

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