Advancing Your Lean Journey

Lean Operating System

To remain effective, healthcare services need to deliver higher and more reliable quality, safer care, and faster patient access—and accomplish all of this at the lowest possible cost.

JWA Consulting guides your organization through the five levels of the Lean journey.

The first two levels build stability into your clinical and administrative processes, initiate daily management, and begin to build a culture of engagement and continuous improvement.

 Level 1 – The Foundation:

  • Train Lean leaders
  • Attend study missions
  • Plan your Lean journey
  • Understand your value streams
  • Recognize that success relies on building the systems around the patient
  • Deploy strategy

Level 2 – Stability:

  • Establish flow and initiate clinical standard work
  • Meet quality and service standards
  • Initiate daily management for success metrics, readiness for each shift, and problem solving
  • Link service line and unit improvements to strategy


Levels 3, 4, and 5 take greater technical and leadership dedication, but this is when the benefits of the Lean system substantially increase.

Level 3 – Match Capacity to Demand:

  • Level the schedule and the work of the day
  • Control workflow (“air traffic control”)
  • Begin to operate to takt (cadence) and dramatically improve patient flow and lead times
  • Set staffing to demand

Level 4 – A Takt Environment:

  • Set standardized work with detailed cycle times, successive quality checks, and triggers for process-stop to meet the standard
  • Refine clinical standardized work
  • Implement advanced daily management to enable managing to standardized work, level flow, and immediate andon response

Level 5 – Optimize:

  • Refine leaders’ and the workforce’s problem-solving skills

Innovate to improve access, cost, empathy, quality, and safety


Read more about JWA’s advanced Lean work at Advanced Lean