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 learning, reinvented
May 3, 2022
Lean learning, reinvented

INTERVIEW – From hospitals to start-ups, lean principles have been applied far beyond their origins at Toyota. This article discusses how lean can be applied to learning – specifically, how we can apply lean learning to learning lean.

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Facing the crisis with an appetite for improvement
May 6, 2020
Facing the crisis with an appetite for improvement

NOTES FROM THE VIRTUAL GEMBA – Despite a 40% drop in sales and the looming prospect of having to furlough part of its staff, this French company is finding in lean manufacturing an ally to fight the current crisis.

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The A3: more than a sheet, a language of progress
January 7, 2026
The A3: more than a sheet, a language of progress

FEATURE – Effective problem solving through A3 requires shared observation and dialogue, not perfect documents; when teams learn together across boundaries, improvements address root causes and endure.

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Embrace not knowing
September 22, 2026
Embrace not knowing

MY AHA MOMENTS – The author reflects on how embracing uncertainty, curiosity, and systematic problem solving can overcome resistance to Lean and create a culture of continuous improvement.

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