NC Rural Hospitals Lean Together to Zap Waste

"It doesn't mean, 'you go to this meeting,'" he said in an interview. "It means, 'I'm at this meeting and you follow me.'"

So what does it mean to be a hands-on CEO? Haywood said that he spends a minimum of 5-6 hours per week dedicated to some form of lean training. Easton said she began her hospitals' lean journey with weekly e-mails to each of her managers "trying to indoctrinate them into the lean way of thinking."

Because in actuality, "lean" seems to be as much a mindset as a strategy.

"It's a philosophy; it's a whole way of looking at the work," Easton said. It's not always easy to get everyone onboard, but it helps when the CEO is, as Haywood calls himself, the "head cheerleader."

"I'm an old dog," he said. "But I sure can tell you they can be taught new tricks."

Even though the hospitals in both collaboratives are still working on trimming the waste in their organizations—becoming truly lean can take years—they're already seeing big results.

"Over time you just see that your top metrics have really moved," Easton said. "You have higher satisfaction, you have reduced staffing, significantly less dollars that you're spending, your expenses go down, your physician satisfaction is better. We have much improved on-time starts."

Add to that, Haywood said, improved patient satisfaction. In just a few months of trying to improve its surgical value stream, Dosher's measured outpatient satisfaction has been at 100% for several months.