Introduction : an accidental redesigner -- Craft, flow, mass -- Taiichi Ohno and the birth of lean -- The principles of lean thinking -- Health care is not manufacturing -- Knowledge work -- Redesigning care : authorisation, permission, teams and governance -- The virtuous circle of process redesign and the health care -- Identifying the problem -- Defining the scope -- Diagnosis (1) : mapping -- Diagnosis (2) : direct observation -- Identifying the real problem -- Measurement -- Goals, the scientific method and the future state -- Strategies (1) : Value stream, batching and flow improvement -- Strategies (2) : targeted interventions, visual management and visual systems -- Strategies (3) : queues, prioritizing, capacity and demand -- Embedding and sustaining -- Redesigning emergency department flows : case study -- The care-after-hours program : case study -- Visual management : case study -- Redesigning podiatry care : case study -- Process redesign for healthcare using lean thinking.

Process Redesign for Health Care Using Lean Thinking is a response to a simple, but hard to answer, question and is the result of the experiences of a working doctor who was also the chief safety and quality officer of an Australian teaching hospital. At this hospital, he observed that the Emergency Department was staff by talented, well-trained, and respected doctors and nurses. The facilities were modern, and the work load unexceptional, but the department was close to melt down. Bad things were happening to patients, everyone was blaming each other, lots of things had been tried but nothing was getting better and no one could explain why. The problem was not a lack of technical knowledge or expertise, the problem was that no one stood back and said, "what’s the best way to move 200 or 300 patients a day through the complicated and varying, sequence of steps needed to sort out the many different problems that bring patients to our department?"