Leaning in to Succeed in Public Hospitals

Joanna Omi, Principal, Rona Consulting Group
Anne Boyd Rabkin, Senior Community Benefit Program Manager, El Camino Hospital


Lean has been written about extensively as a philosophy and management system embedded in a culture of continuous improvement and learning. Initially employed to transform Toyota, Lean includes multiple tools that are all aimed at involving staff at every level in organizational change.

Seeking an enduring way to thrive in an increasingly competitive marketplace, public hospital systems Zuckerberg San Francisco General Hospital and San Mateo Medical Center adopted Lean methodologies. Through the application of Lean principles, practices, and tools, these organizations have embedded the systems and infrastructure needed to stabilize and align resources to achieve strategic goals. When it comes to engaging the workforce in finding and eliminating waste and improving quality, safety, throughput, and financial health, these hospitals serve as examples of “what good looks like.”

Key findings include:

  • Lean methodologies are most successful when staff at all levels commit to them.
  • Both hospitals found that daily huddles and roundups enabled them to more easily share ideas and improvements.
  • San Mateo Medical Center credits Lean with part of its success in reducing a waiting list of thousands down to zero.
  • Lean processes can take years to institute, but are a worthwhile investment.

This paper profiles the improvement journey of these two medical centers with insights and challenges from chief executives Susan Ehrlich, MD, and Chester J. Kunnappilly, MD. They describe the process as long term and transformational.

The full report is available for download below.