At the Community Medical Center in Missoula, Mont., Orthopedic Surgeon Doug Woolley was frustrated. A bottleneck in the recovery room limited to four the number of total joint replacements he could do each week; he figured he had time to easily do one more.

He asked Cindy Jimmerson, a nurse turned medical researcher who works with the hospital to implement lean, for help. "So we did our observation," says Jimmerson. "We observed very good nurses working very hard and saw a bunch of system problems -- little tiny things that they work around without even thinking.

"We found three or four things that were not too big that we could [improve] -- things like posting somebody's beeper number in an obvious place, so they didn't call somebody else to call somebody else. We made those changes very quickly and tried them out the next Monday."

The result? They reduced time in the recovery room from 90 minutes to 62 minutes.

"Over four patients that gave us two more hours, which was more than enough time to recover another patient," says Jimmerson.

Simple Stuff; Dramatic Change

Think about it: After one lean event, the doctor, anesthesiologist and hospital are more productive. The patient's bill (which adds up by the minute in the intensive care recovery room) goes down. The nurses feel better about their work because they're not so frustrated by the work-arounds. Access to care for the patient -- who now waits six weeks to get in -- improves 20%. And the quality of care is improved.

"Simple, simple stuff makes really dramatic change," asserts Jimmerson.

Why should executives of manufacturing companies care what's happening in a 135-bed hospital in Montana? Because you're paying for it, and they're at the leading edge of a new effort that could dramatically reduce the amount you pay for health care -- bringing lean management principles to a cash-sucking cyclone that so far no one or nothing else has been able to stop.

Further, says Jimmerson, "You have to demand this, because you're paying insurance premiums, paying when errors to your staff [keep them out of work longer than necessary] . . ."

She points out that even the seemingly insignificant delays in an average doctor visit costs your company. To see a doctor for seven minutes, it's common to wait 15 or 20 minutes, she notes. "You're filling out replicate paper work, sitting in the waiting room, waiting in the exam room in your paper gown -- that's not care, that's all non-value-added waste."