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Implementing Lean in a Safety-Net Clinic: A Case Study

American Institutes for Research

Lean, an organizational redesign approach focused on eliminating waste, is increasingly being used in health care. A case study evaluates its use at a Federally Qualified Health Center.

Lean is an organizational redesign approach that began in the manufacturing sector but is increasingly being used by health care organizations to improve efficiency, clinical outcomes, and financial performance.

To better understand Lean's application in ambulatory health care, the American Institutes for Research (AIR) conducted a case study at a large urban, multisite Federally Qualified Health Center (FQHC) in California. The health center began Lean implementation in 2008, anticipating a 10-year process.

The report includes data on efficiency, organizational culture change, employee engagement, and Lean process knowledge and skills. Efficiency measures included patient cycle time, third next available appointment, appointment completion rate, and provider productivity. This information was supplemented by site visits, staff interviews, and staff surveys.

The research provides a close look at Lean's effectiveness, as well as insights and lessons learned during the early implementation period.

A summary fact sheet and the full case study are available as Document Downloads.

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