“There are tens of billions of dollars being spent on construction of new healthcare facilities in the U.S. today. Before spending another dime healthcare executives should read this book and learn how it’s possible to take as much as 40% of the building cost out before a shovel ever goes in the ground. This result has now been proven over and over by many healthcare organizations on the Lean transformation journey. As a bonus, but even more importantly, we can improve staff satisfaction and clinical quality at the same time as the cost goes down. Naida Grunden and Charles Hagood beautifully document these outcomes by the use of real case studies in addition to her own extensive experience as a careful observer of Lean healthcare.”

John Toussaint, MD
CEO, ThedaCare Center for Healthcare Value

“‘Lean-Led Hospital Design’ is a work we’ve all been waiting for. The authors do a tremendous job consolidating this relatively new body of knowledge into a practical, applicable application that will impact millions of people, enhancing value delivery by removing non-value added waste from the patient experience.”

Mike Orzen
Shingo Prize-Winning Author of “Lean IT: Enabling & Sustaining Your Lean Transformation”

“High quality care and patient safety are requisites of the healthcare delivery system. This book is a must for every Lean practitioner with its practical real-time examples of facility improvement that engage front-line staff to remove waste and improve outcomes.”

Debra N. Thompson, Ph.D., RN
Principal, Debra N. Thompson, LLC and Adjunct Faculty, University of Pittsburgh, School of Nursing

“Naida Grunden and Charles Hagood have produced a miraculous book integrating smarter and continually improvement management and architectural design. Just practicing the new management which dates back to last mid-century Japan has helped several hundred American hospitals cut costs by 50 percent, get rid of hospital-acquired infections and drastically reduce medication and medical errors saving untold lives. Constructing hospitals with the input of knowledgeable managers, doctors and nurses, who are themselves continually learning, hopefully is the key to solving America’s hospital and care delivery crisis. Gruden and Hagood have produced the next leap forward in consciousness and improvement.”

Clare Crawford-Mason
Producer, NBC White paper, “If Japan Can, Why Can’t We?” PBS Documentary, “Good News: How Hospitals Heal Themselves,” and Co-Author of “The Nun and the Bureaucrat: How they Found an Unlikely Cure for America’s Sick Hospitals”

“This book by Naida Grunden and Charles Hagood speaks with engaging clarity about how Lean can and should be used as the guiding philosophy for designing hospitals. One compelling feature is its systems perspective that is sensitive to the interrelated roles of people, processes, leadership, and culture in making Lean work. Another is its emphasis on actionable understanding through a great selection of concrete examples, case studies, images, and insights from experienced practitioners. I cannot think of a better primer on Lean-led hospital design.”

Rangaraj Ramanujam
Associate Professor of Management, Owen Graduate School of Management, Vanderbilt University

While there are may be many faces of Lean, including process design and facility design, these many faces share one expression – no outcome, no income. Grunden and Hagood have done it! Their latest book points the way, in everyday language, as to how we can achieve an improvement in the quality and outcome of care and save money and reduce error at the same time. This book is a guide for survival under an era of accountability and will drive the ‘no outcome, no income’ agenda deep into the second decade of the 21st century.

David B. Nash, M.D., MBA
Dean, Jefferson School of Population Health, Thomas Jefferson University

“Finally! Proof that Lean can do for hospitals what they have already so spectacularly done for industry: improve processes, create dramatic bottom-line results, and align the work culture…and now, while saving lives. Grunden and Hagood make an irrefutable case. Hospital infrastructure in the United States in a disastrous state of decay and insufficiency. The need for new structures—and new paradigms of thinking—is urgent. All the more reason for getting this book into the hands of hospital management, administration, and planning—as well as architects, contractors, and builders. A beautifully researched and logically delineated book, “Lean-Led Hospital Design” is a ‘must read’ for everyone associated with hospital running and planning—preferably before any action is taken in the old ‘design-bid-build’ sequence.”

Gwendolyn D. Galsworth, Ph.D.
Visual workplace expert and Author of “Work That Makes Sense & Visual Workplace/Visual Thinking”

“Wonderful examples abound throughout this book and the underlying Lean concepts are articulated in a vernacular that is readily absorbed. Perhaps the quintessential example is the homage paid traditionally to waiting areas and lobbies, which in their modern and technical splendor, sentences the patient to wait and provide testimony to preventable waste. What if patients never waited? What could be saved in building costs if a healthcare facility did not require these vestibules? The concept of waiting is supplanted by Grunden and Hagood with examples of how work redesign and complementary space redesign are the essential ingredients in creating the seemingly elusive state of patient centeredness in healthcare as an alternative to waiting.

The book is a must read for any healthcare CEO and their directors who are contemplating a building campaign. Adherence to the brilliant, yet laconic concepts in this book should be a moral requirement akin to the legal debt covenants that will certainly accompany the planned construction or renovation. No project should be considered “shovel ready” without embracing and applying these ideas.”

Richard P. Shannon, M.D.
Frank Wister Thomas Professor of Medicine at the Perelman School of Medicine Chairman of the Department of Medicine of the University of Pennsylvania Health System

“Leading lean hospitals have learned they need more than ongoing continuous process improvements. Given the chance to build new or expanded facilities and space is a unique opportunity to build in efficiency and patient-centered care from the start. “Lean-Led Hospital Design” is a fantastic book that shows the reader exactly how to incorporate process design with space design in a collaborative and iterative manner. The vivid examples shared by Grunden and Hagood bring these principles and practices to life. This book will help your organization immensely, whether you are just starting to plan for a new facility or whether you are ready to move in.”

Mark Graban
Author, “Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement” and “Healthcare Kaizen: Engaging Front-Line Staff in Sustainable Continuous Improvement”

Hagood and Grunden have engaged one of the most complex and important subjects facing our great nation. This generation’s place in American history is taking shape, and in no small part, will be valued on how we responded to the healthcare cost crisis. This book provides useful insight as to how we can design care that fulfills its obligation ‘to do no harm’ and yet provide it in a cost effective manner.”

John Bardis
Chairman, President, CEO
, MedAssets

“There are many books on Lean management, but this one really sets itself apart in its clarity and readability.  Grunden and Hagood offer a thorough discussion of Lean management techniques in building design.   They share real-life stories of healthcare leaders and design teams who took the time to analyze their processes and ultimately achieve incredible project and operational savings through facility design.  It’s written in a compelling tone (once you start, you’ll keep reading) providing a clear and actionable path to improved design.”

Margaret F. Schulte, DBA
Healthcare Consultant, Author of “Healthcare Delivery in the USA”

“Naida Grunden, author of “The Pittsburgh Way,” and Charles Hagood have nailed an important oversight in Lean and other industrial engineering applications in health care. Too little attention is focused on the role of the environment and physical plant in making exceptional performance possible. Would a world-class symphony perform in a substandard hall with poor acoustics, uncomfortable seats, audible distractions and visual impediments? Excellent case studies demonstrate how health facilities can be designed to advance safety, clinical quality and efficiency.  This book argues effectively that performance excellence must be aligned with a supportive physical environment.”

Karen Wolk Feinstein
President, Jewish Healthcare Foundation of Pittsburgh, Founding co-Chair of the Pittsburgh Regional Health Initiative

“Lean techniques and tools have been transformative in our organization as a means of systematically analyzing processes and office design to eliminate waste. However, the beauty of Lean principles is that the goal is not simply to eliminate waste or increase efficiency but to ensure that change is always patient centered and driven by the front-line workers who interact with these patients every day. Lean principles help us to keep our patients at front and center whenever we are contemplating changes. In Grunden and Hagood’s “Lean-Led Hospital Design,” they write with great clarity and wisdom about how  lean principles can be used to create the ideal Hospital of the future.”

Eileen Boyle, MD
Executive Director, East Liberty Family Health Care Center

“Grunden and Hagood have produced an authoritative, compelling argument for adopting the principles of lean management integrated through all aspects of hospital management from architectural design, construction through delivery of clinical care.  In several examples they document the gains to be enjoyed in more functional design, construction cost savings, operational efficiencies, and more satisfying work conditions for healthcare professionals, and – most important – for the safety, satisfaction, and improved outcomes for patients.  The unifying vision for building design and healthcare operation is ‘what is best for the patient.’”

Robert W. Mason
Managing Partner, CC-M Productions, Washington, DC