I want to add a couple of more items to the post below about John Billi's MIT-sponsored webinar about Lean at the University of Michigan Health System.
When the Lean approach was first adopted at UMHS, there were some notable successes which I would term "projects." For example, a rapid improvement event was held to redesign the carts used for blood draws, using the 5S approach that I have often referenced on this blog. Here's the "before" view:
And here's the "after" view:
This is all good stuff, but it is not a full-fledged implementation of an organizational philosophy. What UMHS found out is that the cultural change inherent in Lean takes a long time to become embedded in the firm. At BIDMC, we used to talk about "tortoise not hare" when we described that. In essence, the process of adopting Lean becomes a Lean process itself. It is one of modesty and constant learning. Look, for example, at what John presented for the coming agenda for his institution.
The other point John made is when a map is constructed to enable all to all aspects of the value stream, "it's not the map that's valuable. It the process of mapping, which produces a shared understanding of the value stream and which enables the front-line team to design improvement experiments together."