In 2003, ThedaCare formally started the ThedaCare Improvement System (TIS) to engage staff in continuous improvement using Lean ideas adapted from manufacturing. Early work emphasized value stream analysis (mapping an end-to-end process) and rapid improvement events (short, focused team problem-solving). This created a common method for reducing delays and errors while keeping patient needs central.
From 2003 to 2008, ThedaCare used value stream analysis, rapid improvement events, and targeted projects across multiple processes. This period helped teams learn to see “waste” (non-value-added work like rework, waiting, and unnecessary motion) and redesign daily workflows. The emphasis on structured problem-solving set the stage for later efforts to sustain gains beyond one-time projects.
In 2006, ThedaCare used TIS to design a new inpatient care approach that later became known as Collaborative Care. The model focused on reducing clinical risk and wasted time by improving teamwork and creating clearer, shared plans of care. This design work connected Lean tools (like mapping and standard work) to a visible change in how patient care teams function.
By the mid-2000s, ThedaCare publicly described significant financial impact from its improvement work, including estimates of large annual cost reductions achieved without layoffs. The organization framed these savings as linked to process redesign that also aimed to reduce medical errors. This helped build internal and external credibility for Lean as more than a cost-cutting program.
In February 2007, ThedaCare began piloting Collaborative Care in a redesigned general medicine unit at Appleton Medical Center. A key feature was interdisciplinary teamwork (physicians, nurses, pharmacists, and others) to reduce handoff errors and delays. Early reporting highlighted improvements such as shorter lengths of stay, supporting the case for spreading the model.
In 2008, ThedaCare leaders created the ThedaCare Center for Healthcare Value to teach Lean management and share lessons beyond their own hospitals. Establishing a separate education-focused organization signaled an intent to spread methods, not just complete internal projects. It also helped formalize training, coaching, and peer learning as part of ThedaCare’s broader improvement strategy.
By 2008, trade and industry reporting on ThedaCare’s Collaborative Care described around a 20% reduction in length of stay on the pilot unit. The reporting tied those results to redesigned roles, tighter collaboration, and real-time coordination tools on the unit. This moment helped position ThedaCare as a national example of adapting Lean ideas to inpatient care delivery.
In 2009, ThedaCare began piloting its Business Performance System (BPS) to embed continuous daily improvement into managers’ routine work, not just special events. The published description reports an “alpha” phase across six units completing in July 2009, with later pilots expanding to more units. This shift addressed a common Lean challenge: sustaining gains and making improvement part of everyday management.
From September 2009 to January 2010, ThedaCare expanded BPS into a “beta” pilot across additional units, applying visual management, structured problem-solving, and leader standard work (agreed routines for checking performance and removing barriers). The intent was to make performance gaps visible and to help teams solve problems quickly. This expansion marked a move from isolated improvement success to a system for spread.
ThedaCare applied Lean methods to clinical “flow” problems, including door-to-balloon time for heart attack patients needing emergency catheter-based treatment. A later synthesis of Lean hospital case examples reports ThedaCare reduced average door-to-balloon time from 92 minutes to 37 minutes over multiple years. This illustrates how Lean was used as a patient-safety and outcomes strategy, not only an efficiency tool.
In September 2010, ThedaCare began spreading BPS to a third cohort of units, continuing into early 2011. The reported results emphasize measurement across safety/quality, customer satisfaction, people engagement, and financial stewardship—so improvement did not depend on a single metric. This stage reflects the program’s maturation: standardizing how leaders manage improvement so it persists through daily work.
In September 2011, The Joint Commission Journal on Quality and Patient Safety published a detailed account of ThedaCare’s Business Performance System and why it was developed after earlier Lean work. Publishing the model made the program more transparent and teachable, allowing others to evaluate and adapt it. It also provided an external, citable summary of how ThedaCare tried to move from projects to continuous daily improvement.
By 2012, reporting on ThedaCare’s Lean work included performance trend data through that year for door-to-balloon time, showing sustained improvement over a multi-year period. Using a long-run clinical metric helped demonstrate that process changes could be maintained, not just achieved briefly after a project. This provides a clear closing outcome for the 2003–2012 era: Lean evolving into a measurable, system-managed way of operating.
ThedaCare's lean healthcare program (2003–2012)