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Invited Commentary
January 2017

Building a Lean, Mean Patient Care Machine

Author Affiliations
  • 1DeWitt Daughtry Family Department of Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Florida
  • 2Department of Surgery, Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, Florida
JAMA Surg. 2017;152(1):48. doi:10.1001/jamasurg.2016.2834

Widespread negative media attention targeting patient access and wait times at US Department of Veterans Affairs institutions has prompted evidence-based reform to improve health care access and delivery. When it became clear that the country’s largest integrated health care delivery system was underperforming, Congress created the Commission on Care in 2014 to evaluate and reorganize the Veterans Health Administration to better serve veterans.1,2 One such way to improve efficiency and eliminate waste is through lean process strategies, which are now widely used across various industries to improve quality.3 At its core, lean methods aim to maximize value while minimizing waste along the entire value stream.4

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