title: Lean health care: what can hospitals learn from a world-class automaker?
abstract: BACKGROUND
  With health care costs continuing to rise, a variety of process improvement methodologies have been proposed to address the reported inefficiencies in health care delivery. Lean production is one such method. The management philosophy and tools of lean production come from the manufacturing industry, where they were pioneered by Toyota Motor Corporation, which is viewed as the leader in utilizing these performance improvement methods. Lean has already enjoyed tremendous success in improving quality and efficiency in both the manufacturing and the service sector industries.
  
  
  RESULTS
  Health care systems have just begun to utilize lean methods, with reports of improvements just beginning to appear in the literature. We describe some of the basic philosophy and principles of lean production methods and how these concepts can be applied in the health care environment. We describe some of the early success stories and ongoing endeavors of lean production in various health care organizations. We believe the hospital is an ideal setting for use of the lean production method, which could significantly affect how health care is delivered to patients.
  
  
  CONCLUSIONS
  We conclude by discussing some of the potential challenges in introducing and implementing lean production methods in the health care environment. Lean production is a novel approach to delivering high-quality and efficient care to patients, and we believe that the health care sector can anticipate the same high level of success that the manufacturing and service industries have achieved using this approach. Hospitalists are primed to take action in delivering care of greater quality with more efficiency by applying these new principles in the hospital setting.
authors.affiliation: Division of General Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan 48109-0376, USA. seoungk@med.umich.edu
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Kim
authors.forename: David A
authors.initials: DA
authors.lastname: Spahlinger
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Kin
authors.forename: John E
authors.initials: JE
authors.lastname: Billi
mesh_terms: D001336:Automobiles / Q000191:economics; D003695:Delivery of Health Care / Q000191:economics / Q000379:methods / Q000458:organization & administration*; D017598:Efficiency, Organizational / Q000191:economics; D006739:Hospital Administration / Q000191:economics / Q000379:methods; D006801:Humans; D007221:Industry / Q000191:economics / Q000458:organization & administration*; D007858:Learning; D009936:Organizational Innovation; D017749:Total Quality Management / Q000191:economics / Q000379:methods / Q000458:organization & administration*