Dice Game (LEAN)

Thu, 08/11/2016 - 15:25 -- gkroberts

Hi, I am planning a kaizen workshop and introducing the LEAN framework. To bring these concepts into life, I thought it would be nice to play the dice game; however, now I can't find any information on how to implement the game. Has anyone done this before or know how to facilitate this game? Please help!


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Submitted by annhollingsworth on

I am also interested if you find out more about the dice game.

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Submitted by gkroberts on

Hi Ann,

Out of all of the google searches for dice game instructions we found, we liked this one the best, and adapted it to public health by simply adapting the roles to reflect clinic patient flow.

LEAN DICE GAME (20 minutes)

The dice are merely there to show the process, in this case, 1 dice is 1 patient going through the patient flow. At the first process step, the participant must turn all the dice so the one is showing. At the second step, the next participant must turn it so the two is at the top. And so one.

Materials: Obtain 10-15 multisided dice per group of 5-8 people. Transparent dice and ones with un-inked numbers can help make the exercise more challenging (and realistic).


  • Inspector: Ensure rules are followed, add up points for all dice that completed the process
  • Timer: Times each round
  • Team: Each person on the team will turn the dice in a certain way to represent a specialized activity, such as 1. check-in, 2. registration, 3. vital signs, 4. nurse encounter, 5. lab, and 6. check-out.
  • For smaller groups, the inspector/timer, 1/2, and 4/5 can be combined.

Time limit: 1 minute per round

Here’s the description of the Game: 1 die represents 1 patient going through the patient flow. Goal: get as many patients through the patient flow as possible in 1 minute.

  • Patient Check-in would be performed by turning a die and placing it on the table such that the number 1 is facing up.
  • Patient Registration would be performed by turning a die and placing it on the table such that the number 2 is facing up.
  • Patient Vital Signs would be performed by turning a die and placing it on the table such that the number 3 is facing up.
  • And so on (Nurse Encounter-4, Lab-5), ending with the Check-Out, who turns the dice one more time to the number 6 to accept them.

Feature Scoring: Teams get 1 point for every die that has been completed (proceeded through all of the defined activities by turning the dice through each number). For instance, if you defined five activities (e.g. check-in, registration, vital signs, nurse encounter, lab, and check-out), the die would have to be turned to 1, then 2, 3, 4, 5 and 6 sequentially; when it reaches 6, it is Done and gets the point.

Rounds: Do 4 rounds, and after each round, ask the following questions:

  • After round 1: ask the team to eliminate waste using LEAN principles to increase the number of patients seen in 1 minute.
  • After round 2: ask teams to share best practices to encourage collaboration rather than competition
  • After round 3: tell the team that the Check-out #6 person called in sick, so they will need to figure out how to cover that role with their current resources.
  • After round 4: ask team what they learned, what they liked, how they could use LEAN principles in their work processes, etc.

I hope this helps! Feel free to contact me if you have any questions.

Source: https://lean6sigma4all.eu/lean-dice-game/

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Gurleen Roberts, MPH
Director of Quality Management
Cobb & Douglas Public Health
Marietta, GA

Submitted by techols on

Hi Ann & Gurleen,

Another option for a fun activity that can be used to introduce LEAN concepts in a Kaizen framework is the koosh ball exercise.  I did this exercise in one of my PMQI meetings and the group really had fun and was able to digest the concepts a lot easier.

I got the idea from a Kaizen workshop I attended at the end of last year's Spring PHIT Conference.  The workshop was excellently put on by Pam Vecellio of Continual Impact LLC.

I have attached the slides that are specific to the exercise.

Tara Echols, MBA, SSGBC  


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Tara Echols