Posted by: Knightbird | July 30, 2010

Frustrated Again and Again

In December of 2006, as I blogged about earlier, I wrote a letter to the leaders of 2 of our largest Alaska Native healthcare organizations pleading with them to examine Lean Healthcare. I got the typical bureaucratic response, which is to be ignored.

In the meantime, Denver Health attacked Lean Healthcare with what was described in the following article as with “the fervor of a religious conversion.”  ( Since 2005, which is shortly after Chugachmiut started its lean conversion, Denver Health says it has benefitted to the tune of $54 million.

This just leaves me frustrated again. We have patients who are suffering long wait times, a lack of services and myriad other problems that  could start becoming resolved by a good lean cultural transformation. I recently had the new interim hospital administrator and interim quality control administrator to Chugachmiut to show them the results of lean management. Yet they are interim employees, which makes me feel like I have wasted my time. When will the leadership, the board and CEO, step up and care enough about their patients to mandate the change.

I have been reading Anna Roth’s blog titled “Doing Common Thinks Uncommonly Well.” She is exercising the kind of lean leadership that we need in Alaska. There are many others doing the same thing, to great advantage for their patients, I might add.


  1. I really think it’s going to take a critical mass of healthcare organizations adopting lean before many others will. I wish I knew roughly what the percentage of healthcare organizations is to reach that tipping point and how far we are from it. Like an individual organization’s lean journey takes years to take root, I think an entire industry’s (like healthcare) journey will take even more years, if it happens at all. In the meantime I share your frustration.

    I don’t know to what extent lean thinking is gaining a foothold in the American education system, but if it were at least making its way into the curriculum in colleges at all we would be making some progress. To have lean thinking be a college major, minor, or have some of it as elective coursework would eventually go a long way toward spreading it. I know lean thinking can’t be reduced to institutionalization, but like any discipline the learning is continuous.

    I can honestly say that having facilitated continuous improvement off and on for the last 18 years or so, and having been exposed to a number of philosophies, lean is, to me, far superior to any others… But that’s a whole ‘nother discussion…

    • Thank you for your comments, Mark. As a beneficiary, I have both a business and personal stake in seeing the tribal health system improved through Lean Healthcare, at least until a better model comes along. My patients also include many of my relatives, and too many of them have suffered at the hands of the system. I feel the need as a customer of the system to push our leadership to enlightenment.
      I once asked a Professor at a business school if they offered training in TPS, and he had not heard about it. SInce then I have considered not knowing about lean as similar to educational malpractice. Bravo to those educational institutions offering instruction in Lean management.

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