Leveraging Lean in Medical Laboratories

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Lean and Change Management

All progress comes from change, but not all change is progress.

—Unknown

If you want to go fast… go alone, if you want to go far… go together

—Unknown

Change management is not only a large part of Lean, it also occurs before, during, and after any

Lean implementation. One should not underestimate the importance of this component to success-

fully disseminate, deploy, and sustain Lean.

IMPLEMENTING LEAN IS ABOUT BALANCE

We have a saying that Lean is 50/50 task vs. people. Fifty percent of Lean is implementing Lean

tools. This is the scientic management part of Lean. The other 50% of Lean is the “people” or

“culture” piece which requires signicant change management. There must be a balance between

these two pieces. If the Lean balance scale swings too much to the scientic management side, we

can end up with low morale and discontent with the ultimate result being unionization. If we swing

too far on the people side, then we end up with no discipline on the oor and no chain of command.

People do whatever they want to do, are not accountable, hoard their knowledge (to protect their

job), and are out of control. That is why striking this balance before, during, and after the ongoing

improvement phase of Lean is so important.

LEAN CULTURE CHANGE

While learning and implementing Lean tools is not easy, implementing the people piece or what

Toyota calls “Respect for Humanity” is much more difcult. The people piece includes encouraging

people not only to buy-in and accept Lean, but also to embrace and sustain the changes. The real

goal of Lean is to create a continuous improvement culture where employees are contributing ideas

every day and supervisors or team leaders have budgeted 50% or more time to implement these

improvements on a daily basis.

Lean is a very difcult culture to create. In discussing this with Jerry Solomon, multiple Shingo

Prize winner,

1

Jerry said, “Why would you want to embark on the Lean journey when over 90%

ofcompanies fail in their quest to truly become Lean? What will your company do differently to

be successful?”

Lesson Learned

It is extremely important if you are starting a Lean journey that you contemplate and truthfully

answer the question above. We ask this of any healthcare institution or department even thinking

about going down the Lean path. Think through it, plan and map it out, get the right people on

board, don’t waiver, and never look back. Hopefully, we can reverse this to 90% of companies

being successful in implementing Lean and Six Sigma.

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Jerrold Solomon, Accounting for World Class Operation (Fort Wayne, IN: WCM Associates) 2007, Who’s Counting (Fort

Wayne, IN: WCM Associates) 2003. Both books won the Shingo Prize.

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