If you want proof that logistics is a matter of life and death, visit your local hospital. Better yet, make a trip to New London, Conn., and visit Lawrence & Memorial Hospital. Tim Cavanagh will walk you through the logistics of life and death.

Cavanagh is director of process innovation at this hospital—a title you won’t find at too many hospitals around the country yet. Then again you won’t find too many people like Cavanagh, either. He’s been a student of the Toyota Management System for 20 years and is Six Sigma trained. So why is he working at a hospital?

Bruce Cummings, CEO of the hospital, has had a history of applying industrial best practices in a hospital setting—and it has served him well. While at Olean General Hospital in New York, Cummings hired a Motorola engineer to streamline processes. He also hired a former Dresser-Rand Group executive as vice president for human resources. These two worked in tandem to help the hospital avoid bankruptcy.

Did the fact that Cummings wanted Cavanagh to apply logistics disciplines to Lawrence & Memorial’s inefficient processes surprise him? Not at all. “To lean guys like me, healthcare is one of the last frontiers to attack process waste,” Cavanagh says.

Being the last frontier, Cavanagh expects the terrain to be rugged. Part of that is dealing with cultural changes, since many in healthcare aren’t sure this stuff will work. In fact, some say patient care will be degraded by treating it as a series of processes. Cavanagh has heard all the arguments against Lean and Six Sigma—many of them have been made by those on the industrial side.

Cavanagh has won the doubters over by focusing on process, product, and people, as well as exposing root causes. He does this by involving the front line stakeholders. In manufacturing, those are the operators and the people who inspect the product. In healthcare, it’s nurses, doctors, and technicians. These are the people who don’t typically get a voice in the processes ruling their lives.

Thinking lean in a hospital requires simple mechanisms for triggering actions back to the supplier. Ideally, the supplier will get a signal when a nurse takes something, whether it’s gauze or a specific medication. When supplies reach a certain level, a signal is sent back into the system for replenishment. You want replenishment to involve the least number of steps back into the hospital and onto the floor, in the right size and quantity, delivered to that nurse without a lot of hands or effort. That requires a tight relationship between the supplier and the hospital.

It also requires process mapping, starting with how the customers, products, services, and processes flow. “We tracked the nurses, watched them go back and forth to the supply room, back and forth to the med room, back to linens, and found they were traveling over five miles a shift,” he notes. “We looked at how we could get all these things closer to the point of care. As a result, our nurses can now spend more time with the patients.”

And doctors are getting more involved with patients up front. To Cavanagh, failure to do this is what’s causing this country’s emergency departments to struggle. Lawrence & Memorial is experimenting with having doctors triage incoming emergency department patients, starting a treatment plan right there.

“Why should that person have to wait three or four hours and 25 steps into the process before they see a doctor?” Cavanagh asks. “Until you walk a process and map it, you don’t see the waste. My job is to teach people to see the waste.”

When waste reaches the emergency room—or the plant floor for that matter—you’re just seeing the symptoms of a disease that’s rooted further back in the organization. In a plant, the disease could reside in engineering, product development, or customer service. In the hospital, it could be on the nursing floors, in the labs, or in the records room.

No matter where the disease lies, good logistics management is the cure.