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In the 1960s, automaker Toyota came up with its Toyota Production System (TPS), a means of reducing waste without sacrificing quality. TPS evolved into lean thinking, a strategy for eliminating all that is unneccesary, thereby highlighting the necessary. The lean approach has since spread from manufacturing to nearly all sectors. In 2007, the first Global Lean Healthcare Summit took place in the United Kingdom, and hospitals have been experimenting with lean thinking ever since. Fiona Keogan, a service improvement lead with the Ireland East Hospital Group, explains how her organization is applying lean thinking to health care with satisfying results.

About the Author

Fiona Keogan works with the Ireland East Hospital Group as a service improvement lead.


In Ireland, hospitals operate independently from the social welfare system. As a result, there’s been a disconnect affecting the longer-term community service providers, physicians and hospital staff, all of whom work with the same patients. The Ireland East Hospital Group used lean thinking strategies to improve workflow and bridge the communication gap.

First, hospital staff participated in values and visioning workshops and created a value stream analysis for each site. Then, hospital staff and community workers attended a Rapid Improvement Event (RIE), where...

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