Operationalizing lean health assets

HERD. Winter 2010;3(2):13-29. doi: 10.1177/193758671000300203.


Objective: To demonstrate the potential of employing unconventional facility/facilities management (FM) performance indicators in healthcare settings to enable more strategic conversations between FM and business users concerning asset performance.

Background: The theoretical background for a Lean asset approach and a high-level analysis of data from hospital trusts in England have been published elsewhere. This paper reports on the first uses of that approach in operational settings.

Method: Observations are drawn primarily from three case studies.

Results: The individual studies support the premise that the conventional emphasis on cost per square meter (m(2)) as a preeminent measure of FM disguises a portfolio of too much underutilized space. They provide a means of putting a healthcare estates strategy in terms that will engage business users.

Conclusions: Despite a growing interest in Lean approaches in healthcare, the philosophy has not yet been extended to the estate. This study demonstrates that alternative benchmarks are possible.

MeSH terms

  • Efficiency, Organizational*
  • Hospital Administration / economics
  • Hospital Administration / methods*
  • Hospital Design and Construction
  • Humans
  • Organizational Case Studies
  • Organizational Innovation
  • State Medicine
  • United Kingdom