How Lean Six Sigma Can Improve Healthcare Processes

Identifying the 8 Forms of Waste

Lean Six Sigma is a fact-based, data-driven philosophy for improving processes that values defect prevention over defect detection. It combines the Lean and Six Sigma philosophies to improve performance by reducing variations in workflow and minimizing the waste that exists in all processes. This post specifically discusses these types of waste within the context of healthcare, where defects can be more fatal than any other industry.

According to the Institute of Medicine, an estimated 98,000 Americans die annually due to medical mistakes. That makes medical errors the third leading cause of death in the United States. Additionally, an estimated 1.3 million people are injured in American hospitals annually, according to a Harvard University study. Lean Six Sigma offers solutions that can eliminate waste, prevent defects and cut those numbers significantly.

Lean generally defines waste as the use of any material, space or time that doesn’t add value to a product. Japanese industrialist Taichi Ohno was an early pioneer of lean manufacturing who identified seven forms of waste, which are the first seven discussed in this post. The eighth form has been identified by Jim Womack of Massachusetts Institute of Technology (MIT).

1. Defects

A defect is anything that requires correction, which can have grave consequences in healthcare. Common examples of defects include an imaging error, mislabeled specimen or specimen with no label at all. Defects require resources such as time and material to correct, which incurs a direct cost for an organization.

2. Waiting

Waiting in healthcare can include waiting for material to arrive, waiting for the next step in a procedure to be completed or a patient waiting to see a medical practitioner. Waiting is a waste for an organization because it accomplishes nothing, while still requiring personnel to be paid for their time. This is one of the most common ways that healthcare organizations waste their resources.

For example, before applying Lean Six Sigma, walk-in emergency room patients of North Shore University Hospital in Manhasset, New York were experiencing wait time averaging 187 minutes. After the bottlenecks in the process were identified and addressed using Lean Six Sigma techniques, that wait time decreased by 37%, according to an article by Villanova University.

3. Overproduction

Overproduction occurs when a process produces more material than the next step requires. This form of waste has a direct cost in manufacturing, which uses capital that could have been used for more useful purposes. Overproduction may also result in a storage cost, which is at least an indirect cost. However, storage can also become a direct cost if the extra product isn’t used before its shelf life expires.

4. Overprocessing

Overprocessing is the performance of activities that consume resources without
providing additional value. Adding features to software that will never be used, and testing that doesn’t provide additional information are common examples of
overprocessing in healthcare.

5. Excess Inventory

Excess inventory is a form of waste that’s very similar to overproduction, primarily since it also incurs storage costs. Unnecessary storage incurs a cost that isn’t the best use of an organization’s capital, which can become prohibitive when inventory exceeds available storage. Similar to the waste of overproduction, excess inventory can lead to material waste due to spoilage.

6. Motion

Motion is a form of waste resulting from the unnecessary movement of people, which usually involves other forms of waste. People in motion are typically unable to accomplish their primary duties and may need to spend additional time on other tasks such as searching for materials or information. Poor filing and retrieval systems often result in a waste of motion.

7. Transportation

Transportation involves the movement of material, which occurs when the material isn’t at its point of use yet. Each time you need material that isn’t at your location, that material must be transported before you can use it. Transportation time is therefore a form of waste closely associated with waiting. Furthermore, transportation costs aren’t the best use of an organization’s resources.

8. Underutilization

Womack identified underutilization as an eighth form of waste, in addition to the other seven recognized by Ohno. It refers to the underutilization of human capital, meaning someone’s talents aren’t being used in the best way. This type of waste often occurs when someone is overqualified for their position, preventing an organization from making full use of their potential.


  • Lean Six Sigma is a data-driven philosophy to improve processes. It combines the Lean principles and Six Sigma philosophies to improve performance by reducing variations in workflow and minimizing the waste that exists in all processes.
  • Medical errors are the third leading cause of death in the United States. Therefore, a significant opportunity for process improvement exists within the healthcare industry, where defects are often fatal.
  • There are seven forms of waste identified by Japanese industrialist Taichi Ohno, who was an early pioneer of lean manufacturing concepts. Jim Womack of MIT identified an eighth form of waste.

At Vector International, our experienced process improvement consultants use Lean Six Sigma tools and methodologies with our clients to eliminate waste, optimize processes, and implement controls to ensure enhancement and sustainability in healthcare and other industries. Our goal is to help your business achieve operational excellence. For more information, contact us now!

Key Behaviors to Succeed in a More Virtual Business Environment

1. Be in the virtual meeting space.

Use your video camera, engage and speak with presence, be an active listener, make sure everyone has a voice.

2. Embrace the technology.

Manage your virtual people network; facilitate remote working and operate in standard IT platforms.

3. Continually improve.

Value and reward relentless elimination of wasteful activities and more standard  work that relies on visible seamless information, data and knowledge flow (don’t let what you and your customers value be lost in the virtual space).

4. Enable virtual visual management with real-time business performance metrics.

Give everyone real-time access to visible metric dashboard and empower them to use the data for rapid problem-solving.

5. Promote diversity and inclusion.

Think and act with an inclusive mindset.

Lean Six Sigma in the era of Artificial Intelligence (AI)

Almost every company you can think of, every application, it’s going to be affected by Artificial Intelligence (AI)….You are going to be using Artificial Intelligence (AI), or you are going to be outpaced by people who are”—  Brian Krzanich, CEO, Intel, Wall Street Journal, October 23,2017


The notable shift from simple digitization to advanced technological innovation, enabled by the advent of artificial intelligence (AI), has forced organizations to reexamine some key industrial practices. One such practice is that of business process improvement.

Over the past decades, Lean Six Sigma process improvement methodology has delivered proven gains in efficiency and productivity to both manufacturing and service-based organizations.  Artificial intelligence (AI) can be leveraged to extend that value and drive even greater and more rapid improvement throughout the organization.  Nevertheless, in order for organizations to realize the full value from its AI investment it is necessary for the organization to first develop important organizational capabilities, such as process standardization, with the help of programs such as Lean Six Sigma.  Hence, it is this author’s position that AI does not replace Lean Six Sigma, rather it enhances it while benefiting from its core practices.

What Can Lean Six Sigma Training & Practice Offer?

Data Competence

A core element of Lean Six Sigma application is strong reliance on data analysis for decision making.  The range of skills involves data collection, identifying and interpreting causal relationships, inferential statistics, etc. Developing such data handling competence through Lean Six Sigma training supports successful implementation of an AI strategy.

Business Domain Proficiency

Knowledge and understanding of core business processes, workflows, roles and responsibilities along with an understanding of process inefficiencies are important pre-requisites for successful AI strategy implementation.

Understanding Changing Customer Needs and Requirements

In the era of AI increased access to mobile networks and data, allows for increased consumer engagement, greater transparency and new patterns of consumer behavior.  According to Kraus, companies will now have to adapt the way they design, market, and deliver products and services.

Leveraging Lessons Learned

Barrier to adoption and implementation of transformational programs such as Lean Six Sigma and Artificial Intelligence (AI) lies within “people and processes”. Organizations that have successfully implemented Lean Six sigma would have learned important lessons that can be leveraged when designing and implementing an AI strategy

Organizations are using Artificial Intelligence (AI) to enhance their overall business operations by integrating algorithms that directly support their core processes. Some AI application involves the identification and analysis of data patterns that the human eye cannot interpret, automating the real time detection of defects during production and the automation of repetitive tasks resulting in improved reliability and accuracy of their process outputs.

Undoubtedly, these and other AI capabilities add significant value to the Lean Six Sigma application.

Nonetheless, the core elements of Lean Six Sigma provide the problem- solving framework and continuous improvement tools, along with the change management and leadership considerations, necessary to realize the full benefits of AI implementation.

Facilitation Can Make or Break Lean Six Sigma Application

For any given business project, the successful application of Lean Six Sigma tools and techniques relies on the collective knowledge, experiences and contribution of a team of individuals.  The challenge then becomes – how does one extract and harness such collective knowledge and experiences through the process of facilitation? Click here to read more