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61OVERPRODUCEPreparing excess surgical kits or medications triggers over-ordering, storage and sterilisation, expired items or unused items sent to landfill. All drive greenhouse gas emissions.INVENTORY ORQUEUESStockpiling drugs and supplies requires energy-intensive climate control, driving up freshwater use for cooling, risking pollution from chemicals and improper disposal. Can also affect the provision of additional space, affecting nature through land conversion.TRANSPORTExcessive movement of staff, patients, supplies or documents between facilities amplifies transport emissions, straining nature and its biodiversity through fuel-dependent logistics.OVERPROCESSRedundant administrative or diagnostics steps may consume additional materials such as single-use plastics. This could drive pollution and hard-to-recycle medical waste.POOR QUALITY /DEFECTErrors in procedures or faulty equipment driving rework, energy and production of trash. In severe cases affecting patient safety and mortality rates.PATIENT WAITING TIMEExcessive queues and delays create overcrowding, driving the need for more waiting areas and accelerating land conversion. This also increases energy use for heating, cooling, and lighting larger spaces, contributing to higher greenhouse gas emissions.EXAMPLESway, sustainability thinking enters daily conversations and drives what teams spend time on. If an institution struggles with execution, often the line of sight is blurred, and therein lies opportunity for lean to help.7 Wastes And The PlanetL ea n a n d sus t ai na b i l i t y s ha r e a symbiotic relationship. Targeting operational waste can directly reduce the environmental impact and cost. For instance, the seven lean wastes depicted in figure 3 exacerbate environmental harm through the inefficient use of resources such as energy, water and materials while generating pollution and landfill waste from medical operations. With global greenhouse gas emissions pushing 4-5% from healthcare alone, targeting these wastes allows hospitals to reduce environmental impacts while raising efficiency and providing more value to patients. W h i l e i n t e g r a t i n g l e a n a n d sustainabilit y thinking brings many benef its, addressing the Execution Gap requires a logical thought-process to guide teams at all levels through th e tr ans fo r mati o n. T his invo l ve s understanding sustainability better, using structured methods to identify hot spots for improvement, and an execution mechanism following cycles of connected PDCA loops. Figure 3: Capitalising on Lean and Sustainability Thinking (Adapted from Heathcote, 2023 and Wills, 2009)專欄文章5 (原文)｜THE EXECUTION GAP