Five Years Lean

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Robbie-EdgeBy Roberta M. Edge, CRA, MHA, FAHRA

In late 2011, the imaging department at Sutter Gould Medical Foundation embarked on our Lean Journey. We began mapping out our value stream at a high level, and then in more detail by each modality. The first couple of years we focused on using Lean tools and easy wins so that staff and physicians could feel this new methodology was “working.” We started with something very simple: wayfinding.

Our Press Ganey score when we started our first event was at P19- not very patient friendly, to say the least. We held our first Kaizen event, and within a few months after, our Press Ganey score for wayfinding was P94 – much more patient friendly. We didn’t do anything miraculous; we just listened to and observed our patients, changed our signage, escorted the patients in, and had them follow the yellow arrows in the carpet for the way out. We do escort out any patient with needs for this, and being in an ambulatory environment, 90% of our patients can simply follow the arrows.

This many years later, the focus is much more difficult. We have shortened wait times, improved access, and built one-piece-flow into several processes. Now the focus is “how do we develop great problem solvers?” How do we coach and mentor our leaders to spend most of their time coaching and mentoring staff to solve problems? How do we change the culture to focus on making every day a good day for our patients, staff, and physicians by having leaders focus on removing barriers so staff and physicians can do their best work?

My leadership team and I have had to learn to move away from the way we have managed for years, the method of “command and control,” to a form of leadership that focuses more on coaching, mentoring, removing obstacles, and an eye always on seeing waste and non-value add activities that keep the team providing care from doing their best each day. Our emphasis each day is on process: what is going in in that process that is keeping the best work from being done?

Please join me for my breakout session, “Five Years Lean” on Sunday, July 31 at 2:30 PM or on Monday, August 1 at 2:00 PM at the AHRA Annual Meeting. In my session I will discuss our Lean journey at Sutter Gould Medical Foundation Imaging Services as well as my personal Lean journey to become an effective Lean leader.

Roberta M. Edge, CRA, MHA, FAHRA is the director of imaging services at Sutter Gould Medical Foundation in Modesto, CA. She can be reached at

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