Lean Healthcare – New Facility DesignOptimizing flow and layout for a new Healthcare facility


·       When a healthcare organization has committed to constructing a new building, it represents a unique opportunity to design the physical layout of a facility to be integrated with and facilitate process efficiencies (see Figure 1). The process of Lean/TPS facility design and layout is a new and exciting discipline, and is able to leverage Lean/TPS tools and methods. 

·       Architects are customarily compensated based on the number of square feet designed, so there is an incentive to maximize the designed space.

·       Staff are asked to speculate on future growth, and this future space is built into the new plan.

·       With the current “use it or loose it” facility management philosophy, departments make use of this future space immediately.

·       Wastes (such as motion, transportation, excess inventory, etc…) result, and when the space is needed in the future, it is not available, and even more new construction is required.


·       Design a workplace that is good for patients, staff, flexibility, technological advances, and growth

·       Integrate staff and physician expertise and process knowledge earlier and much more thoroughly than is done in architectural design processes

·       Increase the percentage of space that is value-added, and decrease the overall square footage when it is not needed

·       Design space that is conducive to visual management, safety, experimentation, and flow

·       Facilitate the full use of team creativity to design multiple future-state design alternatives

·       Demonstrate clear “before” and “after” design and celebrate the teams success and ownership of the new design


        Use low-tech, cheap, and engaging “paper Kaizen” approach  (see Figure 3)

        Need to “Lean the process out before you move”…otherwise, you are moving your old problems into a new building!

        This process will most likely either eliminate, delay, or minimize the cost of the proposed new construction or remodeling (see Figure 4).

        Increasingly collaborative and aligned relationships and incentives with A&E firms, Lean Experts, and hospital Customers need to be fostered.

        The earlier that Lean design principles are integrated, the less expensive these principles will be to include

        When possible, don’t bolt anything down!  Allows for future experimentation and process improvement

        Avoid using cabinet doors whenever possible!

        Make “hard” and “soft” spaces!

        Integrate staff in the development of a more effective, safe, and efficient process before beginning the construction

        Focus on all levels within the hospital (within, between, overall)


Case 1:  Lean Lab Design Project (major remodeling)

  • Customer validated 7:1 Return on Investment (ROI) ($1,240,000 savings) at project completion
  • Reduced lab expansion from 23,238 to 7,489 square feet (68% reduction from 15,749 ft2 reduction in expansion)
  • Accommodated significant growth projections with a much smaller footprint
  • Increased staff engagement and ownership of new design
  • Additional savings of $3,000 and ongoing savings through inventory stabilization project
  • All lab staff trained in Lean, and multiple self-sufficient embedded coaches were developed
  • Metrics board and daily “huddles” integrated into daily lab operations
  • Project presented to senior hospital leadership, which accepted the proposal


Case 2:   Critical Access Hospital Lean ED Redesign (remodeling): 

  • Facilitated a multi-disciplinary team to design an innovating 3 level segmented flow of ED patients.
  • This new design will allow approximately 50-75% more patients to be seen within the same footprint.
  • The team-based design process also decreased the architectural design cost through reduction of individual staff review sessions and the team driving the initial macro-flow layout


Case 3: Lean Clinic Design project (new construction)

  • Decreased clinic space by 7,440 ft2 ($316,200 in savings), as well as accommodating an additional 3,720ft2 due to design reduction (for a total reduction of 11,160 ft2 and $474,300 savings)
  • Decreased walking by the following amounts: Patient (25%), Nursing (27.4%), Provider (57.8%), Overall Average (32.1%)


Case 4:  Rural Healthcare Clinic Lean Design Project (new construction)

  • Decreased square footage (returned to shell for future growth) by 2,720 ft2, and added an additional 1,477 ft2 of revenue generating space not in the original plan, resulting in $231,200 (+$125,545 cost avoidance by accommodating the new space) for $356,745 in total savings
  • Increased revenue of $400,000 per year through new revenue generating areas (Eczema “light box” and optometry department)
  • Decreased walking by the following amounts: Patient (15%), Nursing (9%), and Provider (40.8%)


how can we help you?

Contact us at the Consulting WP office nearest to you or submit a business inquiry online.

“LEAN and the Toyota Way is less about tools, as it is a Mindset of Continuous Improvement and Rapid Learning…Involve the people closest to the work, use simple metrics, trust that the best solutions will be revealed and tremendous engagement will result”

Mike Fitzpatrick
Director, Solar Turbines - a Caterpillar Company

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