Verena Lindenau-Stockfisch 
Lean Management in Hospitals: Principles and Key Factors for Successful Implementation 

The healthcare system of today’s westernised civilisation holds a paradox: on the one hand, hospitals equipped with state-of-the-art-technology and well-educated staff working under best hygienic conditions is regarded standard. On the other hand, our healthcare system is ailing and cutbacks in capital spending, wages and personnel appear on the agenda. Accordingly, a more sophisticated approach that helps hospitals to work efficiently and effectively is needed. Among quality management tools, Lean is one suitable methodology that can help healthcare organisations out of the dilemma. Originally, Lean is a management methodology that goes back to production processes with the main aim to increase output by reducing input. The lean philosophy has its origin in the Japanese manufacturing industry and is strongly bound to the Toyota Production System (TPS). In hospitals, Lean is ideally based on three main pillars: process optimisation, patient-oriented management as well as engaging and leading employees. The first chapter of the book deals with the main principles and tools of Lean to give readers an overview about the basic ideas of this management philosophy. The understanding for waste and wasteful activities will be enhanced and tools such as Kanban, Kaizen and Value Stream Mapping, that are helpful for identification and elimination of waste, will be introduced. Furthermore, new terms and concepts such as Lean Sigma, telemedicine and e-health are examined. For Lean to tap its full potential, human aspects must be considered likewise. One of the most important aspects in hospitals is the successful management of patients. The second chapter concentrates on factors that positively influence the bottom line in a hospital. Thus, patient satisfaction, strategic alliances in the healthcare environment and hospital marketing are of main focus since all these aspects are considered value-adding steps that help to increase service quality and to streamline processes in hospitals. Additionally, effective lean management concentrates on successful leading and engaging employees. Lean management does not happen on its own: it needs visionary leadership and expert knowledge. Lean management calls for a reflected interaction with employees. Hence, the third chapter deals with employee satisfaction and motivation and how this contributes to a sound and proper basis for smooth implementation of lean processes. Implemented correctly, the Lean message is 100% positive because it can indeed create a win-win-win-situation: for the health care institution, the end users – above all patients – and medical staff. But a philosophical issue has to be incorporated into the DNA of the organisation to produce sustainable changes with resulting advantages.