What is lean and what is it doing in my pediatric intensive care unit?

摘要

The Toyota system of continuous quality improvement has been questioned recently as a result of a surprisingly large number of recalls for manufacturing defects (1). However, Toyota has long been acknowledged as a leader in initiating and maintaining processes in its plants that are efficient, effective, and constantly improving. Part of Toyota's success has been its embrace of lean methods. When the uninitiated hears the word "lean," they often think "mean" as in cutting costs, cutting employees, or stretching resources beyond an organization's comfort level. That is not what "lean" should connote. In manufacturing, and increasingly in health care, lean means to eliminate waste and keep only those parts of any process that directly add value for the customer.