I cringe when I hear the word “lean.” Not because I do not believe in the work of the Toyoda family and Taiichi Ohno, and others who ultimately led to the overuse of the term, but because most instances where I hear “lean” have nothing to do with the spirit of that work. 

The expectation is that saying a process, design, or project is “lean” somehow magically enables the delivery of “bigger, better, faster, cheaper” without adjustment. During my lean studies and work on lean projects, I have developed a few tricks, but that is not the fundamental basis of Lean Design.      

The pure intention of a lean approach to anything is to improve processes by eliminating waste; expending resources for any goal that does not add value to the end customer is waste. It sounds pretty simple, but it is a difficult task.  

Process improvement does not always result in less time (on its own); the intention of process improvement is to create a better product by improving that process. A design approach to lean compels us to look inward to what we do as design professionals and examine our processes and discover the waste within them. 

We first need to examine our work and what is broken about the current process. The answer is not always to fix it; maybe we should be doing something else.  We should also look at what is NOT broken, and improve upon it.

Unfortunately, that is something that is rarely done. In design, the biggest hurdle is always communication. Communication is a challenge between the design professionals and the end users, also between the design professionals and the constructors. So instead of fixing what is broken, what happens if we acknowledge it, and instead of learning our counterpart’s language or attempting to teach them ours, we develop a new one? 

Sometimes a conversation, a site visit, or a photograph will save hours of time and reams of paper. Eliminate a hand-off in your process, and you will eliminate countless possibilities of errors. 

Designers are trained problem-solvers. Instead of jumping to solve the problem, though, it may be a good idea to spend time evaluating what the problem is.  We need to make sure we solve the real issue instead of focusing on effects of that issue. There are advantages in healthcare design (one could argue, any design) that could have profound effects beyond what a designer touches traditionally. 

Solving the real, root cause of problems that staff and physicians face, improving the environment for patients, and reducing costs by the designs that support the solution should be the goals of the design, not simply responding to issues users face with their current space. In order to do this we must encourage facilities to develop an ideal state for the operation of their facility and design to support that ideal state. 

If we simply focus on the goal of eliminating any task that does not add value to the end customer we are taking our first big step. Stop and think about it. How much of what you do really adds value to the end product, or if you stopped doing that task, would value decrease? How can we improve how we work and how our customers work? And did you ask your customer what value means to them? 

Oftentimes the waste we eliminate in lean design process improvement does decrease time, and it also usually decreases cost. But that is not the goal we should focus on, that is just a bonus. 

The fundamental reason a lean approach to design should be implemented is to increase value to the end customer. If we as healthcare designers could increase value to the our end customer and enable that customer to do their job better and change their focus to increasing the value to THEIR end customer, now that would be where the magic happens.

Bernita Beikmann, AIA, is Vice President/Project Architect at HKS, Inc. She can be reached at bbeikmann@hksinc.com.