Leveraging Kaizen to Achieve Continuous Improvement

Learning Objectives:

  • Describe Kaizen and how it can help you execute improvement work
  • Recognize the role that staff empowerment plays in sustaining improvement

Too often in healthcare we make an improvement, only to see behaviors and performance revert back to pre-improvement levels as time moves on. What are the causes of this? Why is so much time and energy put into the change, but not into the sustainment? Previously my colleague, Dr. Mark Parker, detailed the Model for Improvement, the framework to structure improvement in a goal driven way. Today, I would like to build off of that and explore Kaizen, a key driver within Lean management to execute and sustain improvement. One of the central components of Lean methodology, Kaizen is simply translated from Japanese as “change for the better.”1


One of the most important characteristics of Kaizen is that it engages everyone that does the work. Within healthcare, this requires that staff and leaders at all levels must be involved in re-shaping the way work is done through a systematic process of asking, empowering, recognizing and sharing. As detailed in “Healthcare Kaizen”, the first principle is asking – eliciting from staff the opportunities for improvement in their work. What can make their work easier? The second principle is empowering – giving staff the ability and psychological safety to take action. What improvements can I make to the work I do every day? What were the results? Are further tests needed? The third principle is recognizing – recording staff improvement and displaying the results. How can we create visibility to the work they are doing? The fourth principle is sharing – spreading improvement ideas throughout the organization to include lessons learned2. How do we engage similar teams in our findings?


True Kaizen begins with executive sponsorship, both from executives and stakeholder leaders. Together they engage the team of subject matter experts at the front-lines to drive the improvement. This includes a charge not only to generate ideas, but to drive the tests of change needed to validate whether improvement occurred by using the plan-do-study-act (PDSA) process. With this work we capture it visually so that the team can be recognized and there is organizational awareness of the work.  This is done by completing an A3, which is a storyboard for Kaizen. Lastly, the team and executive sponsors determine the spread and scalability plan for the new best practice. This culminates in education for staff with the lessons learned from our previous tests of change and the same empowerment to identify further improvements.


Healthcare has strived to achieve lasting change and yet sustained improvement is still one of the great challenges the industry faces3. One path forward is to embrace the Kaizen methodology in all that we do. When we shift our mindset from Kaizen as a tool to the way in which we all work, that is when true culture change has occurred. Without this fundamental achievement, improvements will continue to be incremental and very challenging to sustain.



  1. Kato, Iaso, and Art Smalley, Toyota Kaizen Methods: Six Steps to Improvement (New York: Productivity Press, 2010), 102.
  2. Graban M, Swartz JE. Healthcare Kaizen. Boca Raton: CRC Press – Taylor and Francis Group; 2012.
  3. Mazzocato P, Stenfors-Hayes T, von Thiele Schwarz U, et al. Kaizen practice in healthcare: a qualitative analysis of hospital employees’ suggestions for improvement. BMJ Open 2016; 6:e012256. DOI:10.1136/bmjopen-2016- 012256
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