And so why aren’t hospitals lean? 

One simple answer…incorrect assumptions.  If you are interested, check out this extended piece by Jeff Angus .  It illustrates just how hard it will be to lean out health care.  Assumptions that were once valid become the unquestioned reality of the day.  Even when the assumptions no longer apply.  It is an insidious and difficult issue for us all.   

One of the great contributions of Theory of Constraints is it’s disciplined approach to questioning assumptions.  It is a huge breakthrough when encountering thorny problems or seeming dilemmas.  The application in Lean environments for this is significant.   

I hope this is helpful.