At the recent Built Environment Network meeting (what's the Built Environment Network? Click here to read more!), the Lean process was a prominent topic. Two different presentations were made under the heading "Application of Lean Principles"; The first "Integrated Design Build Project Delivery Model" from David Jarrett, System Director for Design and Construction for Dignity Health, looked in-depth at how that 40-member hospital system based in California, Arizona, and Nevada applies Lean thinking to its delivery methods to align teams both within and outside of the organization to deliver the right projects at the right place, cost, and time. The second presentation from Chip Cogswell and Jeff Williams of Turner Construction Company, "Lean is a Mindset," examined Lean project delivery in a much more general sense, presenting the "Ten Commandments of Lean Delivery."  

While the two presentations came at Lean from different angles, they agreed on a key point: Lean thinking needs to start at the top to be effective for any organization, and it needs to be integrated into the organization at every level. And because the Built Environment Network is comprised of facility-based executives from around the country (and Canada), based in big systems (like Kaiser Permanente) and individual facilities (like Chicago's Rush University Medical Center, which we toured as part of this meeting) and all sizes and styles in between, the members naturally had a lot to say on the topic--and lots of questions.

The question that really stuck with me, however, came the next day as the group was reflecting back on the previous day's agenda. Network member Frank Weinberg, Corporate AVP, Facilities, at MedStar, openly asked the group: can we tip-toe into Lean? Do incremental steps work, and how do I apply them?

So, in turn, I ask you, our HEALTHCARE DESIGN audience: what has your experience with Lean been like? Is your organization incorporating Lean principles and, if so, are you implementing them incrementally or all at once? What has the buy-in been like--from the CEO to the maintenance staff? Lean thinking has proven itself to be more than a mere fad at this point, but there is still some confusion out there as to what it really means to "go Lean" or even how to define it. Let's start the conversation and see if we can collectively bring it all into sharper focus.