Recall your most recent visit to a medical center. You arrived with a unique situation—one that could be categorized under a certain diagnosis and treated in a standardized manner, similar to other patients. Depending on your perspective, you could be seen either as a project, based on your individual complaints, or as part of a process, based on your commonalities with other patients. From the viewpoint of the medical center, you are one of many cases managed using shared resources. In this sense, you can be considered a project, while the medical center functions as a program management facility.
There is a compelling rationale behind this seemingly complex analogy. I’d like to draw your attention to another interesting connection: the application of lean production principles to healthcare. The story of how Virginia Mason adapted the Toyota Production System to transform patient care provides a powerful example of how lean thinking can be transferred across domains.
In 2002, Virginia Mason Franciscan Health, a healthcare organization in the Northwestern United States founded in 1891, launched a system-wide initiative to transform how it delivers care—aiming to improve both patient safety and quality. Based on the Toyota Production System (TPS), this initiative led to the development of the Virginia Mason Production System (VMPS). In 2008, the Virginia Mason Institute was established to offer training on VMPS and promote improvements in healthcare delivery. In 2015, the UK’s National Health Service (NHS) signed a five-year agreement with Virginia Mason to help five NHS trusts implement continuous improvements using Lean principles—demonstrating the methodology’s global credibility and effectiveness.
Virginia Mason made a paradigm shift: from expecting errors and defects to believing that a perfect patient experience is achievable. The key to this transformation lies in understanding that frontline staff—those doing the actual work—are best positioned to identify problems and craft solutions. This approach aligns seamlessly with what any patient would hope for when visiting a healthcare facility: staff who are confident, competent, and capable of resolving issues if they arise.
One innovation that reflects this mindset is the Patient Safety Alert (PSA) system. It requires all staff members to immediately report any situation that could cause harm to a patient and to “stop the line”—halting any activity that could lead to further harm.
While eliminating waste in manufacturing typically means reducing costs, in healthcare it carries deeper significance. In this context, value is defined as delivering the highest-quality and safest care by maximizing the time spent talking with, listening to, and treating patients.
This principle guided the design of a new Critical Care Unit (CCU) opened in 2014. The design team included not only physicians, nurses, and care staff, but also patients and family members. Nurses were assigned to one of three care zones—or “neighborhoods”—to optimize patient monitoring, reduce unnecessary movement, and increase bedside care time. Supplies, medications, and equipment were placed at the point of use, while key functions like supply stocking were centralized. For instance, the unit included special rooms for soiled items that could be accessed by housekeeping through a separate door from the backstage area—ensuring minimal disruption to patient care.
Toyota’s production system empowers frontline workers to prevent mistakes and eliminate waste. Similarly, in healthcare, a rigorous system empowers care teams to reduce errors and waste in patient care. Toyota and Virginia Mason share the same core values: quality, safety, a relentless customer focus, deep staff commitment, and mutual satisfaction for both customers and team members. The result? Cost reduction without compromising resources for either patients or staff. If we see each patient as a project and the healthcare center as a program management facility, then Virginia Mason stands out as a powerful example of how lean principles can elevate both healthcare delivery and, by analogy, project management practice.
REFERENCES
https://www.hfma.org.uk/articles/virginia-mason-cycle-improvement
https://practicegreenhealth.org/sites/default/files/upload-files/case_studies/virginia_mason.pdf
https://www.vmfh.org/about-vmfh/research-care-quality/virginia-mason-production-system
https://www.vmfh.org/content/dam/vmfhorg/pdf/legacy-vm/workfiles/pdfdocs/press/vmps_fastfacts.pdf
https://www.researchgate.net/publication/7269195_Toyota-Style_Management_Drives_Virginia_Mason
