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Table 2 Improvement principles used at the A&E

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


Description of the principle


All people involved in the care process should have an overview of what happens, where one's colleagues are and where the patient is in the care chain.

Link patient care activities

The various activities that compose a patient's care process should, if possible, be linked together or even be performed in parallel.

Takt (work pace)

Different activities can take different time, but the goal is to decrease the variability in the time to complete each step in the process and to achieve a steady work pace to meet projected demand.

First-time quality

By getting things right the first time, quality is improved and the need for rework is reduced.


To the extent possible, patient care processes should be standardized to reduce wasteful patient-to-patient variability.

Continual improvement

Processes and practices can be adjusted several times-by testing, evaluating, and trying again, using a scientific approach-before work flows smoothly