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Shingo Prize-Winning Lean-Led Hospital DesignThe Shingo Prize-winning book is now available in both print and electronic formats! Visit to purchase now!

About the Book

In an era of budget constraints, this much is certain: American healthcare must do more with less. As new legislation encourages hospitals to compete on quality, hospitals must find new ways to provide consistently efficient and excellent care to every patient—at greatly reduced cost.

Fortunately, one approach is showing promise in improving quality and reducing cost: Toyota-based Lean principles of respect, continuous improvement and waste reduction. In hospital after hospital, Lean thinking has led to sweeping process improvements, which in turn have improved care and cost, as well as staff and patient satisfaction.

If Lean is starting to change how hospitals are run, it is also starting to change how they are built.

In their book, “Lean-Led Hospital Design: Creating the Efficient Hospital of the Future,” Naida Grunden and Charles Hagood show convincing ways in which Lean principles can improve the way healthcare facilities are designed.

Generously illustrated with case studies from across the country and the world, “Lean-Led Hospital Design” shows how thoughtful building design can support and accelerate Lean improvements. By harnessing the creativity of every team member from the very start, planners, architects, engineers and construction managers are finding new ways to look at the very function of the hospital. Here are some example insights:

  • A hospital in Kentucky discovers that, by better utilizing its two existing CT scanners, it can eliminate plans to build space and buy two more.
  • A 2-year-old Missouri hospital scraps expansion plans when process improvements and inventory control obviate the need.
  • Lean processes reduce wait times for patients, and reduce inventory. Hospitals plan 30-40% less waiting and storage space.
  • Standardized patient rooms reduce risk, increase safety and reliability.
  • A hospital in Wisconsin, originally planned at 185,000 square feet, is estimated at $85 million. Although the facility grew to 225,000 square feet, final cost was $2 million under budget.
  • Seattle Children’s Hospital built a facility nearly 25% smaller than originally planned, saving $40 million of the original $100 million budget.

The authors predict that new healthcare facilities will be shaped by the imperative of conserving healthcare resources while delivering the best care every time.