Comparing Lean and Quality Improvement


How to cite this IHI white paper:

Scoville R, Little K. Comparing Lean and Quality Improvement. IHI White Paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2014. (Available at


People often want to know about the relationship between the IHI approach to quality improvement and Lean, and how they can best utilize one or both approaches to improve their own care systems. This white paper aims to address these issues, and argues that because both methods are complementary ways of approaching improvement, it is not necessary to choose one over the other as a guide to action.

The white paper provides a brief overview of the issues and some key definitions, followed by more detailed descriptions of Lean and the IHI approach to quality improvement (referred to as "IHI-QI" throughout the paper). For each approach, we discuss the key conceptual foundations, the principles that lead the way to improved system performance, the project roadmaps typically followed under each approach, and the tools that characterize them in practice. We also point out the fundamental congruence between the two approaches, as well as key differences. Finally, we suggest ways that practitioners of both Lean and IHI-QI can use the principles and methods of the other to extend their capabilities.

After reading this paper, you will have clear answers to the following questions:

  • What are the basic concepts and principles of IHI-QI and Lean?
  • How are they similar (in history and approach)? How are they different?
  • For what purposes is IHI-QI the most appropriate approach? For what purposes is Lean the best approach?

 Download White Paper

In this video clip, white paper author Kevin Little addresses the question.​


Do You Have to Choose Between Lean and the IHI Approach to Quality Improvement?

IHI's Gareth Parry offers guidance.​

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