Planet Lean: The Official online magazine of the Lean Global Network
The experience of a value stream manager in a lean hospital

The experience of a value stream manager in a lean hospital

Leonidia Maria Altoé
December 15, 2017

INTERVIEW - What happens in an organization after a move from silos to value streams? In this video, a Value Stream Manager from a Brazilian cancer treatment center shares her experience.


Interviewee: Leonidia Maria Altoé, Value Stream Manager, Instituto de Oncologia do Vale - Brazil


Too many organizations still have a vertical structure based on silos and functions. Lean thinking calls for a dramatic change in the way the work takes place, based on value streams. At IOV, a cancer treatment center located in São José dos Campos, that's exactly what we did.

In the below interview, I explain what the change meant to me and my colleagues, how it made our jobs easier and how it dramatically improved outcomes for patients.


THE INTERVIEWEE

Leonidia Maria Altoe photograph
Leonidia Maria Altoé is a Value Stream Manager at IOV, in Brazil

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Lean leadership means advocating problem solving at gemba
March 15, 2016
Lean leadership means advocating problem solving at gemba

PROFILE – It isn’t every day that you come across a hospital CEO coaching people on A3s and following his own standard work. So when you do, it’s important to share their story. This month we profile the CEO of a Brazilian cancer treatment center.

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Two years of hoshin at the Dutch Ministry of Infrastructure
August 27, 2015
Two years of hoshin at the Dutch Ministry of Infrastructure

FEATURE – The theory of hoshin kanri is clear, but how can you adapt it to a government organization structured in departments where making A3s is not a daily practice? A Dutch ministry shares its experience.

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Learning together: LGN visits Coloplast Hungary
October 14, 2025
Learning together: LGN visits Coloplast Hungary

FEATURE – During a visit last month, members of the Lean Global Network were able to witness Coloplast Hungary’s remarkable Lean progress—cutting lead-times, boosting flow, and strengthening a culture of continuous improvement.

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A lean transformation is a cognitive transformation
November 25, 2019
A lean transformation is a cognitive transformation

FEATURE – By looking at two practical examples, the authors discuss the cognitive shift towards learning and continuous improvement that takes place in a lean transformation.

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