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Lean Healthcare Research Symposium 2026

We are pleased to announce the 10th Annual Lean Healthcare Research Symposium in Houston, TX on March 11th, 2026!

Celebrating Lean Implementation in the U.S. and Around the World

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Advancing Equity: Lean Leader Practices and A Path Forward

A new study from the Center for Lean Engagement and Research highlights how health care leaders are using lean management practices to advance health equity and scale initiatives that ensure high-quality care for all patients. Drawing on in-depth interviews with 67 leaders across five U.S. hospital systems, the research reveals that leadership plays a critical role in embedding equity and workforce diversity goals into everyday operations through lean approaches to process improvement. The authors call for the development of new measurement systems with clearly defined performance metrics...

Associations Between Lean IT Management and Financial Performance in US Hospitals

Justin Lee, BA; Dorothy Y. Hung, PhD, MA, MPH; Elina Reponen, MD, PhD; Thomas G. Rundall, PhD; Aaron A. Tierney, BA; Pierre-Luc Fournier, PhD, MS; Stephen M. Shortell, PhD, MBA, MPH

This study used primary data sourced from 1222 hospitals that responded to the National Survey of Lean(NSL)/Transformational Performance Improvement to understand the relationship between Lean implementation in information technology (IT) departments and hospital performance, particularly with respect to operational and financial outcomes.

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Lean Performance Indicators and Facilitators of Outcomes in U.S. Public Hospitals

Tyler Roey, Dorothy Hung, Thomas Rundall, Pierre-Luc Fournier, Athena Zhong, Stephen Shortell

This study investigated the association between Lean and performance outcomes in U.S. public hospitals. Public hospitals face substantial pressure to deliver high-quality care with limited resources. Lean-based management systems can provide these hospitals with alternative approaches to improve efficiency and effectiveness. Prior research shows that Lean can have positive impacts in hospitals ranging in ownership type, but more study is needed, specifically in publicly owned hospitals...

Improving the US Healthcare System: The Case for Practical Wisdom

A new publication first-authored by CLEAR founder and Professor Emeritus, Stephen Shortell highlights the critical need for a renewed focus on “practical wisdom” in U.S. health care reform.

Despite spending nearly 17 percent of its GDP—totaling $4.9 trillion annually—on health care, the United States continues to rank among the lowest-performing countries in the OECD on key health outcomes. Stark disparities in infant and maternal mortality, hospital safety, and overall care quality persist, especially among minority populations.

The study argues that while numerous reform...

Lean Practices for Resource Use, Timeliness, and Coordination of Care in Breast Cancer Navigation

Dorothy Y. Hung, Paul Kim, Martina Li, Qiwen Huang, Cynthia Cantril, Natalia Colocci, and Ellis C. Dillon,

Researchers at Sutter Health completed a study on making cancer care more efficient and patient centered. Using Lean methods, a BCN program focused on women receiving a breast biopsy was developed at a pilot site and later implemented throughout the healthcare system. After implementing the BCN program, more timely biopsy results were delivered to patients. Patients were more likely to complete an initial consultation within two weeks of biopsy and made fewer outpatient...

Transformational Performance Improvement: Why is Progress Slow?

Dorothy Y. Hung, Justin Lee; Thomas G. Rundall

In this article, the authors identify three distinct transformational performance improvement (TPI) approaches commonly used to redesign work processes in healthcare organizations. They also summarize what is empirically known about the effectiveness of each TPI approach according to systematic reviews of available literature. They discuss what knowledge is still needed to strengthen the evidence for whole system transformation. This involves using conceptual frameworks to assess and guide implementation efforts, and facilitators and...

Managing Through a Pandemic: A Daily Management System for COVID-19 Response and Recovery

Dorothy Y. Hung, Thomas G. Rundall, Justin Lee, Negeen Khandel, Stephen M. Shortell

CLEAR Director Dorothy Hung PhD along with other CLEAR faculty and trainees published a study that explored the use of a Lean daily management system (DMS) for COVID-19 response and recovery in U.S. hospitals and health systems. Originally developed in manufacturing, Lean is an evidence-based approach to quality and process improvement in healthcare. Although Lean has been studied in individual hospital units and outpatient practices, it has not been examined as a whole system response to crisis...