In this series, Healthcare Design asks leading healthcare design professionals, firms, and owners to tell us what’s got their attention and share some ideas on the subject.

Jeffrey Stouffer is a principal and academic and pediatric practice leader with HKS, Inc. (Dallas). Here, he shares his thoughts on Lean design and process improvement and how its potential savings makes it an important design philosophy

1. Lean is a philosophy for business and life (not a marketing gimmick)

To speak with integrity about Lean principles, you have to fully adopt them and apply them to everything, from your office to your kitchen. Design professionals at HKS begin learning to apply this philosophy with a week of 10-hour Lean Six Sigma training sessions. We also recommend clients train their staff members and executive team in Lean thinking. With this knowledge base, projects gain both grassroots support and the support of people at the top of the organization, who can respect the initial time and capital investments needed to achieve the benefits of Lean.

2. Lean design brings value to clients

With the new healthcare paradigm, hospitals need to be more efficient. Staffing and operational costs account for 80 to 90 percent of a hospital’s budget. By making buildings more efficient through well-designed Lean building infrastructure and operational flow we can lower costs.

3. Lean isn’t just about cost; it’s also about quality

Lean designs support higher quality operations with fewer opportunities for errors to occur. As part of a project for Akron Children’s Hospital (Akron, Ohio), HKS and our local partner firm Hasenstab Architects Inc. (Akron, Ohio) led the project team in creating full-scale mockups with all related medical equipment. Hospital staff used these to test how the design influenced their performance in a number of hospital scenarios, such as a woman coming in for an emergency caesarean section. This experiential testing provided valuable information for revising the design to ensure every aspect contributed to high-quality caregiving.

4. Lean is a journey

It’s a good idea to think big but start small when first implementing the tenants of Lean project delivery or process improvement. Instead of creating 10-page meeting reports, document meetings on one sheet of A3 (legal size) paper. Placing all relevant information, such as drawings, photos, notes about responsible parties, and meeting dates, on a single, easily read sheet of paper makes for an efficient document that distills the most important points and encourages collaboration. Developing a pull plan, which begins with the final outcome of a project and works backward to delineate the steps required to get there, is another small step organizations can take towards adopting these work processes.

5. Lean aids in integrated project delivery

In design and construction, Lean creates an integrated project delivery environment that forces interdependency among all partners. Full cooperation between the client, architect, general contractor, and subcontractors results in a project that can cost less, take less time, and result in fewer errors. At Children’s Medical Center of Dallas, our team completed a 50,000-square-foot project in 11 months from operational design to go-live, while maintaining the project’s budget and quality standards.

Jeffrey Stouffer

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