Jenei István

István Jenei: Lean transformation of hospital processes – Structuring foreign and Hungarian experiences,
PhD Dissertation, Corvinus University of Budapest, Doctoral School in Business Administration
To do this the skills of nurses and doctors would need to be broadened (in contrast
to the narrow deepening of skills encouraged by the current system) so that a smaller
team of more broadly skilled people can solve most patient problems. At the same time,
the tools of medicine – machines, labs, and record-keeping units – would need to be
rethought and “right-sized” so that they are smaller, more flexible, and faster, with full
complement of tools dedicated to every treatment team.
Finally, the “patient” would need to be actively involved in the process and up-
skilled – made a member of the team – so that many problems can be solved through
prevention or addressed from home without need to physically visit the medical system,
and so that visits can be better predicted.
Over the time, it will surely be possible to transfer some of the equipment to the
home as well, through teleconferencing, remote sensing, and even a home laboratory,
the same way most of us now have a complete complement of office equipment in our
home offices.
What would happen if lean thinking was introduced as a fundamental principle of
health care?
The time and steps needed to solve problem should fall dramatically. The quality
of care should improve because less information would be lost in handoffs to the next
specialist, fewer mistakes would be made, less elaborate information tracking and
scheduling systems would be required. The cost of each “cure” and of the total system
could fall substantially.
The problem of cures beyond our current knowledge would remain and the
proposed lean transformation in health care is not directly helpful here. However, the
lean transition could free up substantial resources which could be used for fundamental
research to find new cures.
(Womack-Jones, 1996, pp. 289-290.)
The underlying logic of lean health care is clear: as in the motorcar industry, a series of
processes must be implemented for the organisation to attain its goal. “Lean thinking
concepts encourage health care providers to think about the patient’s journey from
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