Quality Improvement in Ambulatory Anesthesia: Making Changes that Work for You

: The pace of busy ambulatory surgical practice makes it difficult to begin and sustain quality improvement efforts. However, evolving patient and payer expectations of high-value care make these endeavors more urgent. Lean, a term coined in 1990 to describe the Toyota Production System, has been applied by large and small health systems to eliminate waste; increase value for customers; and develop the ability of physicians, nurses, and other health care workers to manage and continuously improve their work. This article reviews some of the steps necessary to successfully adopt lean in an ambulatory surgical setting.