CAIRO UNIVERSITY

NURSING COLLEGE

LEAN MANAGEMENT
COURSE TITLE: LEADERSHIP, MANAGEMENT, AND POLICIES IN
HEALTHCARE SYSTEMS
CODE : 02803 LEVEL : DOCTORATE Under Supervision of
2023 Dr. EJLAL AHMAD
DR.ABEER SODAH
DR.SAHR HASAN

Prepared By : Yousef Taha , Nawras Sawalha , Diyaa Amarnah, Fadi

 Objectives :
An expected outcome from a lecture on lean management in nursing could
include:
1-Improved understanding of lean principles: Participants should be able to
understand the basic concepts and principles of lean management in nursing,
including the importance of process improvement, waste reduction, and
continuous improvement.
2- ncreased awareness of the benefits of lean management: Participants should
be able to recognize the potential benefits of lean management in nursing,
including improved patient outcomes, increased efficiency, reduced costs, and
improved staff satisfaction.

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▰ 3- Enhanced ability to identify areas for improvement:

Participants should be able to identify areas in their own
nursing practice where lean management principles could be
applied to improve processes and outcomes.
▰ 4- Improved problem-solving skills: Participants should be
able to apply lean management tools and techniques, such
as process mapping, value stream mapping, and root cause
analysis, to identify and solve problems in their nursing
practice.

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▰ 5- Increased collaboration and teamwork: Participants should

be able to work collaboratively with other members of the
healthcare team to implement lean management principles
and achieve common goals.

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 Outlines :

1- Introduction , defining of quality in general

2- Definition
4- Principles of lean management
5- Use lean management  strategies to overcome  organizational waste : tools
6- Value cost effective use of resources
7- Importance of lean management in health care organization
8- Benefits of lean management to healthcare Organizations:
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 introduction

What is Quality?

▰ Quality can be defined as the degree of

excellence or superiority of a product or
service in meeting the needs and
expectations of customers

▰ Managing Quality: Integrating the Supply Chain" by S. Thomas

Foster, 6th edition, published by Pearson Education. The definition is
provided in the introductory chapter on quality management.

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Continue … definition

▰ One reference for the definition of quality is the American

Society for Quality (ASQ). According to ASQ, quality is "the
totality of features and characteristics of a product or service
that bear on its ability to satisfy stated or implied needs"
(ASQ, "Quality Glossary"). This definition emphasizes the
importance of meeting customer needs and expectations, as
well as the need for products and services to meet specific
requirements or standards.

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Continue … definition

▰ Lean management in nursing is a

systematic approach to healthcare
delivery that emphasizes the elimination
of waste, reduction of variation, and
continuous improvement in order to
provide high-quality, efficient care to
patients.
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 Continue … definition

Specifically, lean management in nursing

involves the application of lean principles
and tools to nursing processes, such as
patient care, documentation, and
communication, in order to optimize
resource utilization and improve patient
outcomes.
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 Lean management importance

▰ By focusing on the principles, healthcare organizations

can achieve a number of benefits, including:

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 Lean management importance

1. Improved patient outcomes: By eliminating waste and improving the quality of care, healthcare
organizations can improve patient outcomes and enhance patient satisfaction.

2. Reduced costs: By eliminating waste, healthcare organizations can reduce costs associated with
excess inventory, overproduction, and unnecessary motion
 Lean management importance

3-Increased efficiency: By streamlining processes and improving the flow of care, healthcare
organizations can enhance efficiency and reduce wait times.

4. Improved staff satisfaction: By involving staff in the process of continuous improvement,

healthcare organizations can enhance staff engagement and satisfaction.
Use lean management  strategies to overcome 
organizational  wastes.

▰ Lean management tools :

• Value stream mapping (VSM)
• Kaizen ( 5s)
• Rapid improvement process
• Standard work
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5- Use lean management  strategies to overcome 
organizational waste : tools

1. Value stream mapping: This is a process of identifying the series of steps involved in
delivering a particular service or product, and analyzing each step to identify waste and
opportunities for improvement.
2. 2. Kaizen: This is a Japanese term that means continuous improvement, and it is a core
concept in lean management. It involves continually looking for ways to improve
processes, products, and services.
3. 3. Standardized work: This involves creating standard work processes that are consistent
across different parts of the organization. Standardized work helps to ensure that
processes are efficient, effective, and of a consistent quality.

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5- Use lean management  strategies to
overcome  organizational waste : tools

▰ 5S: This is a workplace organization methodology that involves

sorting, simplifying, sweeping, standardizing, and sustaining the work
environment. 5S helps to create a clean, organized, and efficient
workplace that supports lean principles.
▰ 5. Just-in-time (JIT) production: This involves producing only what is
needed, when it is needed, and in the amount that is needed. JIT
helps to reduce waste associated with overproduction, excess
inventory, and unnecessary motion.
▰ 6. Pull systems: This involves using patient demand to drive the
delivery of care, rather than relying on a predetermined schedule. Pull
systems help to ensure that care is delivered in a timely and efficient
manner

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 5- Use lean management  strategies to
overcome  organizational waste : tools

▰ Error-proofing: This involves designing processes and

systems to prevent errors from occurring, rather than
relying on detecting and correcting errors after they occur.

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Examples of applying lean management

▰ One example of the use of lean management in nursing is

the implementation of the "5S" system in a hospital's ICU.
This system involves the sorting, straightening, sweeping,
standardizing, and sustaining of the work environment. By
implementing this system, the hospital was able to reduce
the amount of time nurses spent searching for supplies,
leading to increased productivity, less wasted time, and
improved patient care

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Examples of applying lean management

▰ Another example is the use of lean management to improve

the medication administration process. A hospital used
process mapping to identify the steps in the medication
administration process that were taking the most time.
Based on this analysis, the hospital made changes such as
standardizing medication delivery, reducing
communication errors, and ensuring that equipment was in
place before medication administration. This helped to
reduce medication errors and improve the overall quality of
patient care

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two examples of how lean management has been
implemented in hospitals:

▰ Reducing Emergency Department (ED) Wait Times: In one hospital, the

implementation
of lean management principles was used to improve the patient flow and reduce
wait
times in the ED. The hospital used process mapping to identify non-value adding
activities and bottlenecks in the ED process. Based on this analysis, the hospital
made
changes to streamline the patient flow and reduce waiting times.

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 ▰ This included the use of
a "pull" system, where patients were only moved to the next
stage of care when staff was
ready for them, rather than being kept in a waiting room. This
helped to reduce
overcrowding and waiting times, while also improving patient
satisfaction.

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 ▰ Improving Surgical Turnover Time: In another hospital, lean management
principles were
used to improve the efficiency of the surgical unit. The hospital used process
mapping to
identify the steps in the surgical process that were taking the most time. Based
on this
analysis, the hospital made changes to streamline the process, such as ensuring
that
equipment was in place and ready before surgery

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Con….

reducing communication errors, and

optimizing staff schedules. This helped to reduce the surgical
turnover time, allowing the
hospital to perform more surgeries per day, while also
improving patient satisfaction and
safety

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Con….

▰ In summary, lean management principles can be effectively

applied to the nursing profession to reduce waste and
improve the quality of patient care. Examples such as the
"5S" system and the improvement of medication
administration show the potential for lean management to
lead to increased productivity, reduced costs, and improved
patient outcomes

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Con…

▰ Improving quality and reducing waste are key objectives

for healthcare organizations, and they are often closely
related. When healthcare organizations focus on improving
quality, they are working to deliver better patient outcomes,
reduce medical errors, and enhance patient satisfaction.
Reducing waste, on the other hand, involves identifying and
eliminating processes that do not add value to patient care,
such as overproduction, excess inventory, or unnecessary
motion.

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Lean management principles

▰ Lean management involves a systematic approach to

identifying and eliminating waste, while also improving the
overall quality of patient care. This can be done by focusing
on the following key principles:

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Lean management principles

▰ 1. Value: Identify what is most important to patients and

focus on delivering it.
▰ 2. Value stream: Map the sequence of activities that
contribute to the delivery of a specific
▰ patient outcome, and identify and eliminate processes that
do not add value.
▰ 3. Flow: Streamline processes to minimize waste, improve
efficiency, and reduce errors.

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▰ Pull: Use patient demand to drive the delivery of care, and
ensure that care is delivered in
▰ a timely and efficient manner.
▰ 5. Continuous improvement: Continually seek to identify
areas for improvement, and
▰ implement changes to address them.

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Benefits of applying lean management principles

▰ By focusing on these principles, healthcare organizations

can achieve a number of benefits, including:

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Benefits of applying lean management principles

▰ Improved patient outcomes: By eliminating waste and

improving the quality of care,
▰ healthcare organizations can improve patient outcomes and
enhance patient satisfaction.
▰ 2. Reduced costs: By eliminating waste, healthcare
organizations can reduce costs associated with excess
inventory, overproduction, and unnecessary motion

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Benefits of applying lean management principles

▰ Increased efficiency: By streamlining processes and

improving the flow of care,
▰ healthcare organizations can enhance efficiency and reduce
wait times.
▰ 4. Improved staff satisfaction: By involving staff in the
process of continuous improvement,
▰ healthcare organizations can enhance staff engagement and
satisfaction.

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 LEAN METHDOLOGY IN HEALTHCARE

▰ Lean is a set of operating philosophies

and methods that help create a
maximum value for patients by reducing
waste and waits. It emphasizes the
consideration of the customer’s needs,
employee involvement and continuous
improvement.
▰ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171573/

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 Importance of lean management in health care
organization

▰ “The desired outcome of implementing lean in a health care organization is everyday improvement.

“The majority of improvements using lean methodology may seem small, but they can really add up
when everyone is able to find and remove waste from the system by improving their daily work.
▰ improvements using lean result in saving time and resources, shortening patient wait times,
improving physician and staff efficiency and leading to higher satisfaction for patients and providers.

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Importance of lean management in health care
organization

▰ Lean management in health care organizations

attempts to empower staff to generate continuous
improvement through incremental but regular
improvements in work processes.

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Importance of lean management in health care
organization

▰ Objective : to understand whether and how Lean management can be used to

achieve breakthrough improvements in performance
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 Benefit of applying principles of lean
management

▰ The five Lean principles provide a framework for creating an efficient and effective
organization. Lean allows managers to discover inefficiencies in their organization and
deliver better value to customers. The principles encourage creating better flow in work
processes and developing a continuous improvement culture. By practicing all 5
principles, an organization can remain competitive, increase the value delivered to the
customers, decrease the cost of doing business, and increase their profitability.

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Benefits of lean management to healthcare Organizations:

There are three different categories that Lean principles success in, if implemented
properly:
1- Healthcare system improvements. These mostly revolve around time.
 Improved admission, turnaround, examination, and dispensing times.
 The length of stay coupled with discharge rate, and scheduling times.
2- Outcomes pertaining to patients.
▻ Patient satisfaction, a lower rate of re-admission, as well as a decrease in mortality rate.

3- Outcomes pertaining to employees.

▻ A higher rate of employee satisfaction.
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THANKS!
Any questions?

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 References

▰ https://www.smartdraw.com/flowchart/examples/

▰ http://asq.org/learn-about-quality/seven-basic-quality-tools/overview/overview.html

▰ https://www.sixsigma.com/

▰ https://www.ahrq.gov/

▰ https://asq.org/quality

▰ Lean management. Kanbanchi. (2020, December 3). Retrieved October 22, 2022, from https://www.kanbanchi.com/lean-management

▰ https://pubmed.ncbi.nlm.nih.gov/25077248/

▰ http://familiesusa.org/sites/default/files/product_documents/HSI%20Quality%20Measurement_Brief_final_web.pdf

▰ https://revcycleintelligence.com/news/lean-management-in-healthcare-lowers-costs-improves-quality

▰ https://postgraduateeducation.hms.harvard.edu/trends-medicine/importance-adopting-lean-mindset-culture-health-care-organizations

▰ https://www.creativesafetysupply.com/articles/lean-healthcare

▰ https://theleanway.net/The-Five-Principles-of-Lean
▰ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4851595/
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