The starting point for the development of care and service processes is a systematic description of the current processes, based on which goal-oriented care and service processes are developed. The basis for smooth operation in the future is high-quality process documentation, for example in accordance with JHS 152.

Means to describe processes include:

• Workshop work
• Observation and interviews
• Identifying areas for improvement and making recommendations for action

Process development is not a state of being but based on continuous improvement

Lean development starts by identifying the value an organisation brings to its customers and the operational processes that create value. Value is defined as those elements of a product or service that are valued by the customer. Value should not be understood too narrowly. In health care, value is not only good outcomes, but also, for example, short waiting times, short procedure times, and ease of use.

Lean is always customer-driven. Once the value to the customer and the processes that deliver it have been identified, the elimination of non-value-adding activities, or waste, can begin. Waste includes waiting, under-utilisation of capacity and quality errors. However, waste can never be completely eliminated. Lean is not a state of being, but rather a continuous journey towards perfection.

Lean emphasises action. The traditional Western way is to run a business solely on financial metrics. However, financial success is only the result of quality performance. It is therefore important for an organisation to measure, develop and manage value-generating processes rather than the monetary results they produce.