Skip to main content

Table 1 Lean principles and examples of related practices in manufacturing (adapted from [26])

From: How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children's hospital, Stockholm, Sweden

Lean principles

Description of how principles work

Examples of related practices

Standardize work.

"All work shall be highly specified as to content, sequence, timing, and outcome" to reduce variation in how employees do their work.

Standardized job descriptions.

Connect people and machines that are dependent on one another.

"Every customer-supplier connection must be direct, and there must be an unambiguous yes-or-no way to send requests and receive responses." When a worker makes a request for parts or services there is no confusion about who is responsible for providing it, the number of units required or the type of service needed, and the timing of delivery.

Kan Ban cards (an inventory management system that signals when the consumption of an article creates a demand for replenishment), Jidoka (equipment that automatically stops when quality problems are detected. This defect is signalled to the responsible operators and managers through display boards).

Create seamless, uninterrupted flow through the process.

"The pathways for every product and service must be simple and direct". All production lines are set up so that every product and service flows along a simple and specified pathway and goods and services do not flow to the next available person or machine but to a specific person or machine.

U-shaped physical layout (a layout that allows workers to move between the different tasks that compose a process in a flexible way), assembly line.

Empower staff to investigate problems with the process and to develop, test, and implement countermeasures using a "scientific method.

Staff members closest to the operations investigate root causes of a problem and develop "countermeasures" that are tested and implemented in accordance with the "scientific method" and under the guidance of a teacher.

Employee empowerment, Kaizen events (a team based approach for systematic problem solving).