MOH had embraced many Quality initiatives since 1985 to improve the quality of patient care but there was minimal emphasis on the efficient use of resources in delivering quality care. The drive towards patient-centered care demands a lot more from MOHinterms of resources, whereas in the current economic climate, MOH finds it very challenging to meet all demands satisfactorily. Realizing also that there is a problem of wastage in our delivery processes, MOH needs to find alternative tools to sustain the delivery of quality care in the most effective and efficient manner. 

As part of the Public Service Delivery Transformation by the government, Lean Healthcare initiative was initially introduced to look into reducing waiting time at hospitals. The first project at Hospital Sultan Ismail (HSIJB), JB in 2013 successfully reduced waiting time to receive the first radiotherapy treatment on diagnosis for patients with head and neck cancers and waiting time to see specialists at Orthopaedic Specialist clinics. Encouraging evidence of success at HSIJB, has prompted MOH to apply Lean Methodology at Hospital Tengku Ampuan Rahimah (HTAR) to reduce congestion in medical wards and waiting time for patients at the Green Zone in Emergency Department in early 2014. As of September 2014, HTAR projects have shown promising improvements by increasing the percentage of patients discharged within 2 hours in the Emergency Department from 18% to 70.72%, while in the Medical Ward, Bed Occupancy Rate (BOR) has reduced to an average of 83% andinpatient discharged cycle time increase to 83% (discharged within 4 hours). 

Lean Journey in MOH Malaysia then began to take its tours through 2013 with various expansions to clinical departments and non-clinical areas, and also to different new hospitals to increase customer satisfaction, staff morale, improve productivity, eliminate waste in hospital processes, and improve quality of services delivered. The expansion plans shall be carried out in phases within the 11th Malaysia Plans. 

Apart from that, making Lean into a working culture is a long journey ahead. MOH is committed to ensuring all its staff embrace the Lean concept into their daily working habits, hence improving their service delivery to the patients. The sustainability plan shall be developed within the next five years.