Making Hospitals Work

Making Hospitals Work

Marc Baker, Ian Taylor and Alan Mitchell

How to improve patient care while saving everyone's time and hospitals' resources

ISBN: 978-0955147326

Published: May 2009

Pages: 168

Publisher: Lean Enterprise Academy Limited

Price: £40.00

Discount: 20% on 10+ copies


Making Hospitals Work: How to improve patient care while saving everyone’s time and hospital’s resources

Foreword by Daniel T Jones

For the first time Making Hospitals Work provides a practical roadmap for healthcare leaders seeking to create truly lean hospitals. It outlines a clear framework for focusing improvement activities on the most important challenges facing each hospital.

It uses the same evidence based, scientific method as clinicians use to diagnose and treat medical problems to analyse and redesign the core emergency and elective patient journeys from arrival to discharge. It opens everyone’s eyes to the big win-win-win opportunities to eliminate unnecessary waiting time for patients, to synchronise activities so clinical staff can spend more time caring for patients and to free up capacity by reducing length of stay and cut the overtime and agency budget.

It also introduces the key new role of the value stream manager in gaining agreement on what needs to be done by whom in every department across the hospital. Every step described in Making Hospitals Work has been tried and tested in the three years’ action research that led to this workbook. It is the critical breakthrough to take the next steps on the lean healthcare journey.


  • Foreword by Daniel T Jones
  • Part One: Grasping the Situation: What is our Problem?
  • Part Two: Seeing the Process: What is our Current Condition?
  • Part Three: Analysing the Situation: Learning to Think differently
  • Part Four: Developing Countermeasures: Designing the Future State
  • Part Five: Achieving the Future State: Creating an Action Plan
  • Part Six: Completing the Picture: Redesigning Elective Surgery
  • Part Seven: Reflections and Lessons learnt: What next?
  • Glossary 

What they say ...

“The book's title says it all. The authors of Making Hospitals Work clearly lay out how lean thinking can be applied to fix broken processes and eliminate waste in health care. A ‘must read’ for health care leadership teams striving to improve the patient experience and the work lives of their employees”.

Dr. Jack Billi, is leading the lean transformation of the University of Michigan Health System and Professor of Internal Medicine and Medical Education at the University of Michigan Medical School

“The potential benefit for patients, staff and taxpayers from applying lean to our hospital system is enormous.  This workbook draws on a rich vein of lean expertise and applies it thoughtfully to the challenges involved in transforming patient care services.  It should be required reading for anybody with a genuine interest in improving the way that hospitals work”.

David Fillingham, Chief Executive, Royal Bolton Hospital Foundation Trust, UK and author of Lean Healthcare

“This work is an excellent way for executives and physicians to see how lean can allow them to completely re-think the delivery of care. The authors document how health care executives begin to change when they step back and understand how broken the care system is. The excitement builds as they begin to see the waste and remove it. Reality sets in as they realize how they will have to engage many health care workers to make it happen. This book is entertaining, sobering, and inspiring all in one. It gives us confidence that there is a better way ahead for healthcare”.

Dr. John Toussaint is the President of the ThedaCcare Centre for Healthcare Value, and was the Chief Executive of the ThedaCare Inc hospital system

“This workbook is a path-breaking achievement in applying lean principles to one of the world’s most complex organizations, the modern hospital. The authors show how mangers can clarify and streamline patient pathways from admission to discharge, improving medical outcomes and patient and provider experience while saving resources. Since all of us will need a good hospital some day and countries can easily go broke supporting traditional hospitals as the baby boomers began to check in, I hope that hospitals across the world will embrace the authors’ methods”.

James P Womack, Chairman, Lean Enterprise Institute, USA and author of The Machine that Changed the World, Lean Thinking and Lean Solutions

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