Table 2.

Comparison of application of lean management in manufacturing and health-care organization

Type of problem	Manufacturing organization	Health-care organization	Implication for intensive care
Overproduction	Producing ahead of need	Unnecessary treatment and overuse of diagnostic testing	Clear treatment goals and end-of-life decision guidelines
Waiting	Operators standing idle waiting for other workers or machines to finish	Patient waits for an appointment, for test results, for a bed, for discharge paperwork	Clear admission and discharge guidelines
Transport	Moving parts and products unnecessarily	Taking patients to and from tests, moving patients from one room to another	Diagnostic tests being performed at bed side
Over Processing	Performing unnecessary or incorrect activities	Unnecessary forms, asking the same patient the same question more than once, charting everything instead of charting by exception	Digital system Preventing re-enter of patient data Patient centric rounding
Inventory	Having more than the minimum stock necessary	Overstocked drugs that expire, under stocked surgical supplies that lead to delays while staff search for them	Pooling of inventories within the hospital or even within the region just in time
Motion	Making workers look for parts, tools, documents, etc	Searching for supplies, forms, drugs	Correct and logic labelling of all supplies, forms, and drugs
Defects	Inspection, rework, and scrapping parts that do not meet standards	Making and correcting errors, checking for errors	Clear protocols including feedback mechanisms and e-alerts
Talent Waste	Failure to listen to employee ideas for improvement	Using highly trained individuals to do jobs that could be performed by less expensive personnel, failure to listen to employee ideas for improvement	Focus on ICU physician and ICU nurse specific tasks and outsource tasks such as washing patients, paperwork, and move tasks down from ICU physician to ICU nurse when possible