Allway M, Corbett S. Shifting to lean service: Stealing a page from manufacturers’ playbooks. Journal of Organizational Excellence. 2002;21(2):45-54.

The lean approach has become legendary in improving manufacturing companies' operations and profitability. The same principles can, with equally impressive results, apply to many service-sector firms. This article describes how, through a rigorous five-phase process, an insurance company successfully followed the lean model. 

Koenigsaecker G. The Psychology of Change. Lean Manufacturing Advisor. 2000;4:5-8.

Lean implementation requires a magnitude of organizational change that most have not experienced. Failure to anticipate and deal with anti-change players is the most common reason why lean conversions fail.  

Bushell S, Mobley J, Shelest B. Site visit: Discovering lean thinking at Progressive Healthcare. Journal for Quality and Participation. 2002;25(2):20-25.

Progressive Healthcare, a large multi-specialty group practice, used lean principles to improve their primary care delivery process by removing waste and improving workflow. This article chronicles Progressive's journey to lean and offer lean thinking definitions and background.

Alukal G. Create a lean, mean machine. Quality Progress. 2003;36(4):29-36.

This article offers an overview of lean concepts and the history of lean, as well as suggestions for how to begin the journey.  

Drickhamer D. Lean manufacturing: The 3rd generation. Industry Week. March 2004.

The power of lean and the Toyota Production System (TPS) goes beyond the factory floor applications of 5S and kanban. Future generations must apply the principles and methods to the entire system.

Smith B. Lean and Six Sigma: A one-two punch. Quality Progress. 2003;36(4):37-41.

Manufacturing companies across the United States have discovered that one of the most effective ways to reduce scrap and rework and create a unified concept of continuous improvement is by combining lean/kaizen and Six Sigma. Using the two initiatives together has resulted in superior results to what either program could have achieved alone. Case studies illustrate the successful combination of lean and Six Sigma.

O'connor AM, Llewellyn-Thomas HA, Flood AB. Modifying Modifying unwarranted variations in health care: Shared decision making using patient decision aids. Health Affairs. 2004 Oct 7; [Epub ahead of print].

Patient decision aids have been shown to reduce patient passivity, help patients feel more informed, and can increase knowledge of relative benefits/harm of treatment. Decision aids are also shown to reduce the rate of invasive surgery in favor of more conservative treatment options.

Rother S, Shook J
Brookline, Massachusetts: Lean Enterprise Institute; 2003

The Lean Enterprise Institute's step-by-step workbook is an easy-to-read instruction manual that teaches value-stream mapping to anyone, regardless of his or her background. Includes actual value-stream maps and engaging diagrams and illustrations.

Edgman-Levitan S, Shaller D
Boston, Massachusetts: Harvard Medical School, Department of Health Care Policy; 2003; 2003

The CAHPS Improvement Guide is designed for health plans and medical practices to help them analyze their performance and identify practical strategies for improving patients' experiences with care.

Rutherford P, Lee B, Greiner A. Transforming Care at the Bedside. IHI Innovation Series white paper. Boston, Massachusetts: Institute for Healthcare Improvement; 2004.

IHI Innovation Series white paper

This white paper describes work being done in 13 pilot hospitals to dramatically improve the outcomes and experiences of patients and providers on medical/surgical units, particularly focusing on improvements in safety and reliability; care team vitality; patient-centeredness; and increased value.

Full text available! Click view white paper below.