I've been a student of the Toyota Management System for 20 years, and I'm Six Sigma trained. So why am I working at a hospital?

Lawrence & Memorial wanted someone who has done lean and Six Sigma in industry settings. To lean guys like me, healthcare is one of the last frontiers to attack process waste.

Naysayers claim you'll degrade the quality of patient care. But if you look at manufacturing as an example, you'll hear critics say quality will go down there, too. They're wrong. Quality will go up and business will grow.

The Emergency Department is like the manufacturing floor. Yes, there are opportunities out there, but typically they don't start there. These opportunities have tentacles that go back into engineering, product development and customer service. In the ED the tentacles go all the way back to nursing floors that don't have a good flow in discharge, the labs that don't turn quick enough, and people who are stuck in the hallways of the ED waiting for a bed. Same principle, different industry.

We tracked the nurses, watched them go back and forth to the supply room, back and forth to the med room, back to linens, and found they were traveling over 5 miles a shift. We looked at how we could get all these things closer to the point of care just as they do in the best DCs. As a result, our nurses are not running around as much. They spend more time with patients. Hence the quality of care goes up.

Our head of materials management is spending more time getting suppliers in and working with the front line staff to get them things the way they need them and when they need them. In the past our staff would have to reconfigure supplies in appropriate quantities to deliver care. We found that in working with suppliers, if supplies are packaged for the right application, they're more ready to use.