The road to a lean organization

The ‘lean’ solution lies in the accumulation of small improvements, which will have a huge joint impact.
Peter Willen

The drive that is now present in the organisation and the department ensures that other departments are also ‘keen’ to implement lean in their own department.

Eddy Delporte, Quality Coordinator
Jan Yperman Ziekenhuis

Strategic challenge

The Jan Yperman Ziekenhuis has a growing patient population. Hospitals are simultaneously confronted with declining budgets and a shortage of nurses on the labour market.

The ‘lean’ solution lies in the accumulation of small improvements, which will have a huge joint impact. The following challenges were proposed:

  • Increasing the time spent on direct patient care, including by avoiding non-value adding activities or organizing differently.
  • Increasing staff satisfaction.
  • Making nurses more widely deployable by standardizing certain tasks and materials.


In a first stage, Möbius implemented the lean methodology in three departments: geriatrics, surgery and the oncology outpatient clinic. This was the pilot project for the future implementation of lean in all hospital wards.


To create broad support the staff were involved as much as possible with the implementation. For instance, all the nurses spent three hours immersed in a ‘lean tutorial’. On the basis of theory, practical examples and application of the lean principles they were made aware of the various forms of waste in their daily work.

Oil slick strategy

This strategy implies that one starts small and then rolls out ‘cleverly’ across other departments. It is pointless to reinvent the wheel each time.

During the whole process much attention is given to communication and the aim is to create a ‘contagion effect’. Enthusiastic staff who encourage other staff.

Screening of the three departments

In a first phase, a group of nurses identified the entire course of events in their department with support from Möbius. Various techniques were used for this:

  • Conducting patient interviews.
  • Mapping of the time spent and the disruption of nurses through multi-snapshot measurement.
  • Measuring staff satisfaction. 5S check and collection of photographic material.
  • Time registration to gain insight into the Value Added and Non Value Added activities in the oncological outpatient clinic.

Drawing up a plan for improvement

The nurses then presented the results to their colleagues in the department and together they started to think about practical improvements.

Getting started

The approach to the improvements varied according to the ‘size’: small, everyday problems were resolved with the improvement board, while improvements that could be worked on by the team were approached using the LEAN A3 technique.

5S as a basis: the optimization of the organisation of the departments with the aid of 5S technique

The nurses were given a short 5S training and then went to work to create the best workplaces. The result? Shorter distances to walk, removal of superfluous materials and less time spent in the search for materials by assigning a permanent place to all materials.

Lean A3 methodology for addressing departmental projects

Using lean A3 methodology one searches first for the real causes and then formulates solutions. This creates more focus, more commitment (effort) and less paperwork.

Thus a new way of planning and guiding patients was developed for the outpatient clinic. This resulted in time savings by simplifying the administration, but also in a more organised and useful planning.


The collaboration with Möbius led to the following concrete results:

  • Better organised departments.
  • Assurance of the results and agreements on continuation.
  • A culture of continuous improvement (by the discussions on the improvement board, making small improvement in the department, implementing and monitoring of 5S, …).
  • Increased staff satisfaction.

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