As first responders for medical care, behavioral health, and other urgent community needs, California's public hospital systems serve a disproportionate share of uninsured people and patients with complex health care needs. These institutions are inherently vulnerable to the shifting needs of local, state, and federal forces. Public hospitals must balance their responsiveness to often divergent and emergent requirements with vigilant attention to their core mission. Seeking an enduring way to thrive in an increasingly competitive marketplace, Zuckerberg San Francisco General Hospital (ZSFGH) and San Mateo Medical Center (SMMC) adopted Lean methodologies several years ago. Through the application of Lean principles, practices, and tools, these organizations have embedded the systems and infrastructure needed to stabilize and align resources to achieve strategic goals. When it comes to engaging the workforce in finding and eliminating waste and improving quality, safety, throughput, and financial health, these hospitals serve as examples of "what good looks like." Most recently, the development of daily management systems and the standardization of work processes have been called out as game changers for these organizations, helping eliminate complacency and harness the energy of frontline staff and managers.
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