Principles of Lean Design
January 25, 2016

Lean principles have been applied to the manufacturing process for decades. In fact, the idea of eliminating waste and wasted effort is rooted in manufacturing. The concepts are applicable to many types of processes, yet only within the last 10 years have they begun to gain traction in the design process for healthcare facilities. You may have heard the jargon: 2P/3P, Kaizen, spaghetti charts, value stream mapping, and flow production. But what really happens when they are applied? More importantly, how is the design process improved and what are the benefits to the patient and caregivers?

To find these answers and more, please take a look at this article.



As a philosophy rooted in manufacturing, Lean has its most direct applications in high-volume, repetitive operations, like pharmacy, lab, and materials handling.

However, it would be wrong to assume that only back-of-the-house functions can be improved by applying Lean values. The key precepts of standardization—maximizing value, minimizing waste, pull scheduling and using triggers to stimulate flow—are relevant for every aspect of patient care.

Over the past few years, MSKTD has been applying Lean principles as it designs healthcare facilities. A client recently asked us to redesign the surgery department for their hospital. Like many of the hospitals we work with, the core of the facility was old.  The surgery department and other areas within the facility had been expanded by simply adding onto the original design without fully considering how the additions would impact the flow and efficiency of the surgeons, doctors and nurses.  The current surgery layout was inefficient and needed a major overhaul.  The hospital, with input from MSKTD, was motivated to develop a more efficient layout for the entire surgery department knowing that it would improve the care they give to each patient.

With the hospital’s cooperation, MSKTD engaged in a 4-day 2P design process. The time spent with doctors, nurses, clinicians and administrators was extensive and a major commitment of time. The investment produced so many benefits, including:

 The most efficient layout for improved flow of personnel and materials

 Every participant’s perspective was given strong consideration and implemented into the final design

 “Voice of the customer” has been heard

 Stream-lined design process, resulting in user group input and a 95% complete schematic design

100% buy-in by the hospital staff, limiting/eliminating changes in design at later stages of the process

Upon the conclusion of the week-long 2P Event, members of the team were excited.


“WOW! The 2P Process is a valuable tool that will forever help with construction projects in the future. The relationship and team building between the user group and design team helps pave the way for a successful project.”

Andy Raih
Director of Operations
IU Health Ball Memorial Hospital

We at MSKTD are excited about putting these Lean principles to work for all of our healthcare clients – perhaps for you and your next project?  Give us a call to find out more!