Lean Thinking is a methodology that originally came from manufacturing and was first introduced at Toyota before being applied to many other industries. Originally, Lean was focused on flow, value creation, and waste elimination. But when Lean was introduced into human healthcare, it was discovered that process alone is not enough in people management.

Lean Thinking requires buy-in from all the levels of the organization and has to be embedded in the culture to produce innovation at every level. The modification of classic Lean took place and and Lean Thinking Principles were developed by John Toussaint, Founder and Executive Chair at Catalysis an organization focused on transforming management and instill value in healthcare delivery:

  1. Lean is an Attitude of Continuous Improvement. Managing the health of the work environment should be a never-ending process. When a certain degree of success has been reached, the bar should be set higher.
  2. Lean is Value-Creating. The ultimate goal of Lean in healthcare is to improve value for patients. Getting rid of waste is essential; duplicate or unnecessary processes that don’t create value should be eliminated.
  3. Lean is Unity of Purpose. The purpose of the organization should be well-defined, understood, and shared by every member of the team.
  4. Lean is Respect for the People Who do the Work. Lean leadership empowers front-line staff to make their own decisions, which created the feeling of being in control when dealing with difficult problems at work.
  5. Lean is Visual. The placement of displays in staff areas helps to increase understanding of the application of lean methods, and facilitates communication and exchange of ideas.
  6. Lean is Flexible Regimentation. Standardization of procedures helps optimize the workflow but standards should not be set in stone. The essence of Lean: take nonstandard work processes and transform them into standard processes that improve performance and continue to improve the standard work design. Flexibility is the key.


The key reason for bringing Lean Thinking into the veterinary domain was to empower people at all the levels of the organization to make decisions and to unite front line staff around the purpose. A well-defined purpose that resonates with all has to be well-articulated and shared by all in order to achieve cultural integration post-acquisition. Lean Thinking Principles help to facilitate change management beyond integration — when the engagement of the teams usually drops off and is rarely assessed. Therefore, the result of margin expansion is usually poor.


  • M&A Process
  • Culture/People integration
  • HR Process/Onboarding
  • Core Processes Implementation
  • Strategic Filter
  • Prioritization (WSJF)
  • Talent acquisition
  • Pre- and Post-Acquisition Assessments
  • Training
  • Quarterly Goals/Rock Planning
  • Recruiting at the Hospital Level
  • Change Management


Lean Thinking Principles are fundamental to Burnout Prevention. Classic burnout triggers that are eliminated by adhering to these principles are: Lack of control, values conflict, work overload, unfairness, and breakdown of the community.


It is easier to incorporate these principles at the early stages of maturity, and they should be considered at the inception of the organization, when the teams and leadership evolve and the trust between the corporate headquarters and the front line staff is being established.