Lessons from China
The Center's John Toussaint, MD, and Helen Zak were on the ground in China last month to launch the Mandarin translation of On the Mend.
While visiting hospitals and talking to key leaders, they saw an increasing desire for lean healthcare. In China, just as in the U.S., healthcare leaders know they must do something different.
With 10,000 hospitals, the scale of Chinese healthcare is massive. Yet its problems are exactly the same as everywhere else: costs are sky rocketing, quality is unreliable and mostly unmeasured, and there is no transparency of performance.
China delivers most care through hospitals. Although there are outpatient clinics in many cities, the Chinese consider them inferior to hospital care. You can imagine the bottleneck when hundreds of millions of Chinese try to get everyday care at the hospital.
During the visit, the Center officially launched On the Mend at the China Hospital Forum in front of 3,500 attendees. This also officially introduced Chinese leaders to the previously foreign concept of lean in healthcare. Dr. Toussaint also was invited by the Chinese Hospital Association to deliver a detailed session to a crowd of nearly 300. 
Many Chinese doctors were very excited at the idea of lean. With huge need to deliver better throughput at lower costs, the Chinese, including party leadership, are looking for help.
Dr. Toussaint and Helen also participated in gemba tours at two hospitals: 301, a military hospital of 6,500 beds-the largest in China, and DiTan, an infectious disease hospital that earned its fame as the lead hospital to deal with SARS.
 Two main questions emerged during the gembas: How to share beyond departments and who should lead the value stream.One thing is clear about Chinese hospitals. They have a lot of technology, everything from robots to iPads, but they're missing standard work processes.
China has much to gain with lean and is highly motivated by the very large burning platform of caring for 1.3 billion people. It's the Center's vision to spark this excitement and knowledge in other places around the world as we spread lean thinking in healthcare. | 
