Novant Health New Hanover Regional Medical Center uses Lean methods to continuously improve.


Lean concepts were exemplified by Toyota in the 1930s when Kiichiro Toyoda introduced the Toyota Production System (TPS). In the late 1980s, Jim Womack, MIT graduate and founder of the Lean Enterprise Institute, led a research team that coined the phrase "lean production" to describe Toyota's concept. The lean concept looks for ways to eliminate unnecessary resources so that we can operate more efficiently.    

Lean Tools 

Visual Management is a lean technique designed so that any person entering a work place, even those who are not familiar with the detail of the processes, can rapidly see what is going on, understand and see what is under control and what is not. 

A Kaizen Event is a rapid improvement activity that lasts one week. Kai means "change" and Zen means "for the better". A "change for the better" is translated further to capture the idea of endless continual improvement. To the Japanese, a kaizen is a small suggestion that is carried out by the team members to make the workplace better.

A3 is a term that simply represents the size of paper used; however, what is done on that paper is problem solving in a structured approach to resolve known and observed problems.

5S is a method used to provide workplace organization and housekeeping. 5S stands for the following:

  • Lean-Graphic.JPGSort: Clearly distinguish between what is needed and kept, what is unneeded and thrown out. Keep only what is necessary in the work area. Store frequently used items at the work area, store occasionally used items away from the work area, and dispose of unneeded items.
  • Straighten: Organize the way necessary things are kept, making it easier to find and utilize them. Everything has a place and everything in its place, providing an efficient way to find items.
  • Shine: Floors, walls, ceiling, equipment and furniture are kept in like new condition. The area is kept clean on a continual basis because an unclean environment cannot produce quality care. A clean workplace is indicative of a quality process.
  • Standardized: Each department or area maintains a schedule to insure that the first three S's- Sort, Straighten, and Shine are maintained, preventing regression back to a cluttered and unorganized environment. Items are returned to their designated places after use. The need for special clean-up efforts, which cost time and money, are eliminated.  Clean while the task is small-routinely when a task is complete.
  • Sustain: Practice and repeat the process until 5-S become a way of life. 5-S organization is built into the everyday processes in a continuing, sustaining way. Commitment and discipline toward maintenance is essential in taking the first steps to becoming a World-Class producer. 

Standard Work is the way to sustain the Kaizen Gains.
Without standardization, all improvement will roll back with time.