Leading Through Healthcare Disruption

January 7, 2026 – Carlos Scholz, CEO, Catalysis

As healthcare organizations prepare for what’s ahead, we find ourselves faced with the challenge of doing more with less. How does one continue to deliver high-value, safe care in the face of such disruption? It is important to recognize that this moment isn’t just about survival—it’s a test of leadership.

In 2013, John Toussaint, executive chairman and founder of association corporate affiliate member Catalysis, published “The Promise of Lean in Health Care.” Since then, there have been both successes and failures in Lean implementations, all while navigating major changes such as the Affordable Care Act, rapid technological evolution, and the COVID-19 pandemic.

Why Lean Thinking Matters NOW

Healthcare organizations are facing a major new disruption: the recently passed reconciliation bill, H.R. 1. Its potential impact, including deep Medicaid cuts, stricter eligibility requirements, rising administrative complexity, and shrinking coverage, promises to reshape the healthcare landscape, especially for providers whose role is that of a safety net in their communities.

With the impending disruption of H.R. 1, leaders must address immediate pressures from multiple fronts while maintaining a strategic eye to the future. This is where Lean comes in. Many healthcare organizations have adopted the approach with successful results, including American Hospital Association members such as Zuckerberg San Francisco General Hospital and Trauma Center in San Francisco, California and UMass Memorial Health in Worcester, Massachusetts. These health systems have demonstrated sustained improvements related to cost, quality, access, and patient experience through a long-term commitment to a Lean framework. Together with additional research, these examples create a strong case for Lean as a strategic approach to achieve both short- and long-term success.

What began as a promise for Lean has become a need for Lean. To meet this moment, organizations must commit to moving beyond superficial, tool-based approaches and toward an organization-wide commitment to a principle-based framework.

How Forward-Thinking Organizations Use Lean Principles in Turbulent Times and Beyond

Enable culture by respecting every individual and leading with humility

Disruption creates turnover, fear, and burnout. Resilience is defined by the ability to retain, engage, align, motivate, and grow people, even in challenging times. You can do this by:

Aligning behaviors with performance at all levels.
Using leader standard work—simple, consistent daily routines that keep leaders connected to the work—and supporting coaching, developing, and improving people and processes.
Cultivating a culture of experimentation and learning through problem-solving.
Modeling and reinforcing coaching and curiosity: advise less, ask more, and create psychological safety.
Relentlessly developing people to not just perform but to grow.

Develop an aligned, agile organization through constancy of purpose and systems thinking

A structured and agile strategy deployment system helps teams stay aligned, focused, and adaptable:

Use Hoshin Kanri to align strategy with daily improvement, maintaining focus on the critical few. This Lean strategic planning and management system aligns an organization’s goals and objectives at all levels, focusing on Plan-Do-Study-Act (PDSA) cycles and people development.
Identify and track measures that matter to patients.
Design a disciplined strategy execution system across all tiers, maintaining flexibility and adaptability.
Create a daily management system to link strategy to everyday operations with visible goals, rapid problem-solving, and front-line engagement.

Flow and pull value: Redesign care delivery and access

Projected coverage losses could lead to increased emergency department visits, care delays, and uncompensated care. It’s time to rethink care models:

Leverage Lean design methods such as rapid prototyping of care pathways, value stream mapping of patient journeys, and iterative testing of scheduling workflows to build integrated care teams and pathways that manage patients with coverage gaps and improve access to care.
Co-design continuum of care pathways with community partners for timely, appropriate access to resources.

Relentless continuous improvement: Seek perfection, focus on the process, assure quality and safety, and embrace scientific thinking

New policies highlight the need to reduce administrative and clinical burden and complexity. Focus on reducing waste without cutting value by:

Using process mapping to identify and eliminate waste in any administrative or clinical workflow.
Applying standardized work and creating systems that help maintain and improve it.
Integrating visual management to reduce human error, improve flow, and enhance clarity.

Integrate AI, technology, and business intelligence through a Lean lens

Artificial intelligence is here, and when used well, it can elevate care delivery, reduce burden, and improve equity. To use it effectively:

Define a purpose-driven AI and business intelligence strategy that enhances rather than replaces human capability.
Start with process clarity—map processes and eliminate waste before integrating technology.
Make AI and business intelligence a core capability.

Final Thoughts

Healthcare will continue to face financial, regulatory, and operational challenges that will test even the strongest systems. Lean offers much more than tools; it provides a mindset and leadership framework that prioritizes people, enables disciplined action, and builds agile, resilient teams. Leadership commitment is the greatest success factor. Now is the time for healthcare executives and improvement leaders to lead with courage, clarity, and purpose—and a vision for the future success and sustainability of their organizations. The road ahead is uncertain, but you are not alone.