The "Training Within Industry" program was a U.S. government program during World War II that focused on ramping up war production. The methodology for creating job instructions, managing continuous improvement, and training employees became the foundation for Toyota's approach to Standardized Work as it was taught to them after the war.The TWI approach was also used in healthcare during the war. The approach is being utilized today in a growing number of hospitals as that history is rediscovered.The TWI Institute has resources and historical documents about TWI in healthcare.

This is an "open source" edit-able Google Map that illustrates healthcare sites around the world with a documented Lean effort.View Healthcare Organizations with Lean Efforts in a larger map  You can add sites to the map by clicking on the link above. You can access the map directly via the URL www.leanmaps.com.

The AHRQ has a collection of 12 detailed case examples about the use of Lean and Toyota methods in different healthcare settings.These cases include topics such as: patient safety alerts, community health clinic improvements, operating room cleanliness and productivity improvement, improving handoffs, laboratory redesign for lean, improving on-time surgical starts, nurse protocols to shorten length of stay, improvements in myocardial infarction care, MRSA infection rate reduction, and reducing patient waiting times in primary care.

Here is a list of healthcare organizations that have their own website about Lean:Virginia Mason Medical Center (WA)Avera McKennan (SD)Beth Israel Deaconness (MA)PRHI Perfecting Patient Care (PA)Seattle Children's (WA)  Univ. of Michigan Quality System (MI)ThedaCare Improvement System (WI)