Home Cases ZGT: Continuous Improvement Across 50 Departments with Lean Six Sigma
Challenge

Challenge

Building an improvement culture in a hospital with 50 departments

Approach

Approach

Improvement teams per department, project weeks, and Green Belt training

Result

Result

Many concrete improvements and a 75% success rate

About ZGT

Ziekenhuis Groep Twente (ZGT) is a top clinical hospital with locations in Almelo and Hengelo, and outpatient clinics in Geesteren, Goor, Nijverdal, Rijssen, and Westerhaar. Approximately 200 medical specialists and 3,500 employees provide high-quality care to around 250,000 patients annually. ZGT is Qualicor Europe accredited, TÜV-certified, and, as a teaching hospital, is strong in education and research.

With increasing demand for care and a constant number of healthcare professionals, working smarter is not a choice but a necessity. Ramon Kamphuis and Erwin van Dijk have been the driving force behind the improvement programme within ZGT for decades. Their mission: every department, a little better every day.

customer case ZGT

The Challenge

Continuous improvement had existed at ZGT for some time, but it remained at a project level. Two project weeks per year yielded good results, but improvements did not spread throughout the organisation. At department level, there was no method for independently tackling small daily problems. Workload remained high, and non-value-adding steps persisted.
Symbol consultant Juan Jauregui analysed the situation together with Ramon and Erwin. The conclusion: improvements came from the top or via project weeks, but did not take root at the operational level. Employees lacked the knowledge, mandate, and a structured methodology to improve independently.

Our Approach

Symbol and ZGT developed a three-level programme so that continuous improvement is not dependent on a single approach or a single group of people.

What was specifically done:

  • Improvement teams established per department, only where intrinsic motivation is present. Now 22 out of 50 departments are active.
  • Two training sessions per improvement team: short-cycle improvement and cyclical disruption, directly applied to problems within their own department.
  • Two Lean Six Sigma project weeks per year: three improvement projects per week, go/no-go by the Board of Directors.
  • Twelve Green Belts trained by Symbol using the CIMM methodology. Nine out of eleven participants passed with good grades.
  • Digital portfolio built so that improvements are recorded and shared between departments.

“At ZGT, we want to be better tomorrow than today. As long as it doesn't come at the expense of a patient or colleague, you are allowed to learn, experiment, and make mistakes. Because that's how we get better.”

Results

Metric Before After Improvement
Departments with improvement team 0 22 out of 50 Growing
Green Belt success rate 45% national 75% at ZGT Extensive knowledge
Time savings per department Structurally disrupted 1 hour per day Demonstrable
Embedding improvements No system Digital portfolio active Embedded

75% success rate compared to 45% national average
The improvement teams create a snowball effect: time freed up by one improvement is immediately used for the next project.

customer case zgt

Lessons learned

Continuous improvement fails in many organisations not due to a lack of ambition, but due to a lack of ownership at the operational level. ZGT shows that it works when you give employees the knowledge and mandate to solve small problems independently. Not waiting for a project week or a consultant, but getting a little better every day.

The second insight: motivation is a prerequisite, not a side issue. ZGT only starts an improvement team if there is intrinsic motivation. This upfront selection makes the difference between a team that perseveres and a team that stalls after three months.

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Do you recognise this in your organisation?

An improvement culture that fails to take off. Improvement projects that start but don’t stick. Employees who want to improve but don’t know how.

Symbol helps organisations build an effective and lasting improvement structure. Contact us for a no-obligation consultation.

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