This much is obvious: People are not cars. And yet, the same “lean thinking” techniques that fueled Toyota’s global success in quality and market share are having a dramatic impact on the delivery of health care, and helping the University of Michigan to map a future of medicine that relies on new efficiencies and smart innovations to improve patient care and lower health care costs.

Lean efforts—which reassess work to maximize value and learning while minimizing waste—have been under way at U-M for several years. Recent initiatives cut door-to-balloon times for heart attack patients, reduce the lengths of stay for critical care patients on ventilators, and improve access for new patients to the Urology Clinic.

Lean, Mean Operating Scene

One significant project illustrates the impact of looking at medicine through lean-colored lenses. For a year-and-a-half, Department of Otolaryngology Chair Carol Bradford, MD ’86, turned her operating room into a laboratory—the first anywhere to apply the lean model to head and neck surgery. Not only were she and her colleagues able to identify about 75 hours of wasted time per year within her weekly block of two operating days, they showed that focusing on efficiency and profitability does not have to come at the expense of staff morale, surgical resident education, or patient care.

If the approach were extended to all 35 adult operating rooms over a five-day work week, it could add as many as 6,500 additional hours of OR capacity each year and potentially millions in new revenue, according to the team’s study, which was published in the June issue of the Journal of the American College of Surgeons. “Most of the changes we made were actually pretty simple—like doing certain tasks simultaneously rather than in series,” says Bradford. “But simple things can pay big dividends.”