Where waste hides: The healthcare wastes that matter most

---

People in healthcare expect to be busy. Many choose demanding roles precisely because the work matters. But there is a difference between finishing a difficult day tired from caring for people and finishing it exhausted from fighting the processes and technology that are supposed to support that care.

That second kind of exhaustion has a name. In Lean thinking, it’s called waste, and waste in healthcare costs more than people realise: not just money, but scarce clinical time and, eventually, the capacity to care.

I saw it plainly not long ago, in a room with a group of managers discussing a system critical to their organisation’s income. At one point, I asked a question. A long pause followed while the person I’d asked stared at her screen, then looked up apologetically and said, “I’m waiting for the system to respond. It’s really slow today.”

She was only half right. It wasn’t just slow for her, or just that day. We found that most people using that system had been regularly complaining about its slow performance for years. The unspoken question in the room was the same one staff ask everywhere: when are we ever going to get something better?

For most of us, there is nothing more frustrating than technology that cannot keep pace with the work we are trying to do. At the end of a busy day, when someone is catching up on administration, one more technology glitch can be the final straw.

Sometimes the immediate problem is relatively easy to fix. In this case, upgrading the Wi-Fi and replacing unsuitable devices made a significant difference. But slow technology is only one form of waste. More complex forms can be buried in the processes the technology is supposed to support.

In health and community services, that waste does more than increase costs. It consumes scarce time, frustrates staff and can contribute to burnout. Ultimately, it can reduce the capacity available for care.

Three kinds of waste

Lean thinking identifies several forms of waste. Three are particularly easy to recognise in health and community services.

1 - Waiting

Waiting rarely looks like a serious problem when you consider one delay at a time. A waiting room is efficient for the practice – even if less so for the patient. A referral is in a queue because someone needs to review it. A patient cannot move to the next step until that happens. A clinician may need more information before making a decision, while an administrator may be waiting for someone else to confirm a detail.

No-one is being slow or careless. Each delay may have an entirely reasonable explanation. But connect enough of these small, understandable waits and they create a system in which a surprisingly large share of the time between asking for help and receiving it is simply spent waiting.

But waiting is not experienced equally.

People who understand the process, have the time and confidence to follow up, or have someone advocating for them may be better able to navigate delays. Those who do not can easily slip out of sight. Waiting is therefore not only a productivity issue. It can become an equity issue and, ultimately, a health issue.

2 - Over processing

Think about what often happens when a client or patient makes an appointment. They provide some information when they book, then are asked for much of it again (often on a paper form) when they arrive. One person enters it into one part of the system, someone else copies part of it into another, and later another staff member checks that the two records match.

No one is doing anything wrong. In fact, everybody may be doing exactly what the process requires. That is the problem.

Over-processing is work we have built into the system that does not create corresponding value. Duplicate data entry is an obvious example, but there are many others: unnecessary approvals, repeated checks, multiple hand-offs, excessive documentation and processes designed around the limitations of systems rather than the needs of patients or staff.

Each additional step consumes time. Some of that time comes from administrative teams, some from operational leaders and some from clinicians.

Which leads to perhaps the most important form of waste.

3 - Unused human potential

Consider what an hour of a clinician’s time represents. It is not simply an hour of labour with an associated cost. It is a scarce combination of training, experience, judgement and the ability to provide care.

When that hour is spent reconciling information between systems, chasing administrative processes or doing work that could have been avoided entirely, the cost is not limited to the salary or wage cost. There is also an opportunity cost: what could that person have been doing instead?

For many clinicians, the answer involves the reason they entered healthcare in the first place: caring for people and improving health outcomes. Waste reduction is therefore more than an operational efficiency exercise. It can create more capacity for care.

Clinical and operational leaders may be looking at the same problem.

This distinction matters because conversations about efficiency can quickly become uncomfortable in healthcare. “Productivity” can sound like asking already stretched clinicians to see more patients, work faster or somehow squeeze more into the day. That is not what eliminating waste should mean.

The better question is: how much of people’s existing day is being consumed by work that does not need to be there? An operational leader might look at a process and see capacity, delays, rework and cost. A clinical leader might see time taken away from patients, fragmented care, professional frustration and missed opportunities to improve health. Those are not competing perspectives. They are different views of the same system.

Removing an unnecessary administrative step might improve throughput. It might also give a clinician more time with a complex patient. Fixing a referral process might reduce a queue. It might also mean someone receives care sooner. Improving the way information moves between systems might reduce administrative effort. It might also give a clinician better information at the point where they need to make a decision.

This is where clinical and operational leadership have a clear common interest.

Waste consumes more than time

Repeatedly entering the same information. Hunting for data. Chasing referrals. Correcting avoidable errors. Working around systems that do not fit the way care is actually delivered, or waiting for slow systems to respond.

These things do not just consume time. They consume attention and energy.

Over days, months and years, that friction accumulates. Reducing it will not solve workforce shortages or eliminate burnout. But asking skilled people to spend less of their day on unnecessary work seems a sensible place to start.

Should we automate?

This is where digital technology and AI enter the conversation. When we encounter a slow, manual or frustrating process, the instinctive response is increasingly to find a tool that can automate it. Sometimes that is exactly the right answer.

But there is an important question to ask first: Should this work exist at all?

If three people are entering the same information, automating one of those entries may help. Removing the need to enter it three times would be better. If a complicated process exists because two systems do not communicate, adding AI to navigate the complexity may make it faster. Fixing the underlying information flow may remove the complexity altogether.

Technology is very good at making processes move faster. That is valuable when the process itself is sound. It is less useful when it simply allows waste to happen more efficiently. For this reason above all, review of processes to identify waste and ways it could be eliminated should always come before decisions about automation or systems procurement.

Does it give more time to care?

Before investing in another system, AI tool or automation, organisations can apply a simple test: Does this genuinely remove work and give people time back for something more valuable? For a clinician, does it create more capacity for care? For an operational team, does it remove rework, waiting or unnecessary handling? For a patient, does it make their path through the service simpler, faster or more reliable? And if it does not, are we solving the right problem?

These questions do not require a major Lean programme or transformation initiative. They simply require us to look closely at how work actually happens. Where do people wait? Where is information entered more than once? Where are highly skilled people doing work that a better-designed process should remove? Where are staff compensating every day for problems that have simply become accepted as “how things work”? That is where some of the most valuable opportunities may be hiding.

Because in healthcare, reducing waste is not ultimately about squeezing more productivity from people. It is about making better use of the scarce time we already have, and making more of that time available for what matters most: better care and better health outcomes.

---

CIO Studio helps New Zealand health, NGO, and community organisations see where waste is hiding, and what 'good' looks like once it's gone. For the full picture, download our eBook, Before You Invest in Digital and AI.