Long-Term Care · Healthcare
Kindera Living: Building a Culture of Continuous Quality Improvement
Kindera™ Living is a long-term care operator in Ontario, with 11 homes and a retirement community that is privileged to serve over 3,000 residents across the province. Kindera™ Living has partnered with Leading Edge Associates since 2018 to build sustainable, organization-wide continuous improvement capability that endures well beyond individual projects.
The Challenge
Moving beyond pilot projects
Like many long-term care organizations across Canada, Kindera™ Living faced a familiar set of operational challenges: processes that had grown complex over time, team members spending more time on administrative tasks than resident care, and improvement initiatives that would succeed as pilot projects but struggle to sustain or scale across the organization.
The leadership team recognized that isolated improvement projects were not enough. They needed an approach that would build lasting internal capability, empower site-level leaders to identify and solve problems independently, and create a culture where continuous improvement was embedded into daily operations rather than treated as a separate initiative.
The Approach
A multi-year partnership
Kindera™ Living partnered with Leading Edge Associates in 2018 to build lasting continuous improvement capability across the organization. The partnership has evolved over time, expanding in scope and depth as internal capability grew.
Structured Problem Solving
The partnership began with structured problem-solving initiatives in selected long-term care homes, demonstrating the value of Lean methodology in the long-term care context and identifying internal champions who would become the foundation for broader capability building.
Crisis Response and Quality Improvement
During a period of significant operational pressure, Lean quality improvement tools were applied to streamline the crisis submission process, demonstrating the value of structured improvement methodology during high-stress periods.
Comprehensive Capability Building
The partnership expanded to include Lean Healthcare Belt certification training (White, Yellow, and Green Belt), long-term care quality improvement coaching, quality improvement leadership development, and quality improvement committee guidance and structure. The emphasis throughout has been on building internal capability rather than creating dependency on external consultants.
The Results
Improvement in action
The following projects illustrate how Kindera™ Living team members applied Lean principles to real operational challenges, producing measurable outcomes for residents, families, and team members.
Improving end-of-life care: the Dignity Cart initiative
The ProblemDelays in delivering the Dignity Cart were impacting resident and family comfort during end-of-life care, one of the most sensitive and important moments in long-term care.
The Lean ApproachA team conducted Gemba (where the work takes place) observations of the frontline work and mapped the existing process, identifying specific gaps in process efficiency and timing.
The SolutionThe team developed a 5S (workplace organization tool) checklist and visual process map that standardized the Dignity Cart preparation and delivery process.
- Reduced lead time for Dignity Cart delivery
- Improved consistency across shifts
- Fostered a culture of inquiry, kindness, and continuous improvement
- Lean principles subsequently applied to other daily operations including team member room organization, overtime reduction, continence product distribution, and fall prevention
Reducing food waste and improving meal quality
The ProblemHigh food waste was impacting operational efficiency, finances, and meal quality. Rising food prices were outpacing the Raw Food Cost per Resident Day budget, creating financial pressure while compromising the dining experience.
The Lean ApproachThe dietary team conducted Gemba (where the work takes place) visits, formed a cross-functional team, and held a kaizen event to redesign kitchen workflows.
The SolutionStreamlined kitchen workflows and decluttered prep stations. Implemented inventory and leftover tracking logs. Standardized menu planning with improved forecasting. Established daily kitchen huddles to strengthen team communication and problem-solving.
- Monthly food overspend reduced from $30,403 to $2,258 (August to December)
- Improved meal quality, timeliness, and presentation
- Meals better aligned with resident preferences
- More predictable, dignified dining experience for residents
Internal Capability Built
Improvement leaders across the organization
The multi-year partnership has resulted in a broad base of trained improvement leaders and practitioners across the organization, ensuring every site has the internal leadership to drive and sustain continuous improvement.
Faces of Lean
Culture change in action
This is what a sustainable culture of continuous improvement looks like: visible, shared, and led by the people who do the work every day. The following video features insights from Kindera™ Living team members who were trained and committed to sustaining improvement across their homes and roles.
Leaders from many different homes and roles share what Lean has meant for their teams and their residents.
Key Success Factors
What made the difference
Leadership Investment
Kindera™ Living's leadership committed to Lean as a strategic organizational priority, not a one-time project. This included investing in multi-level Belt certification, supporting quality improvement committees, and creating space for team members to lead improvement initiatives.
Developing Change Leaders
Rather than concentrating expertise in a small group, Kindera™ Living chose to develop a broad base of trained improvement practitioners and leaders. With 45+ Green Belts and 91 Yellow Belts, the organization has trained team members who can identify improvement opportunities and lead positive change.
Community-Driven Approach
Kindera™ Living's organizational philosophy centers on strong, empowered site leadership. The Lean implementation aligned with this philosophy by giving site-level teams the tools and authority to drive improvements relevant to their specific residents, team members, and operational context.
Sustained Partnership
The multi-year partnership between Kindera™ Living and Leading Edge Associates allowed for progressive capability building rather than one-time training events. Each phase built on the previous one, creating deepening expertise and expanding the network of internal improvement leaders.
Lean as the Way of Working
One of the most meaningful outcomes has been the shift in how team members approach their daily work. Continuous quality improvement is no longer a separate initiative; it is simply how Kindera™ Living operates. Team members at every level apply Lean thinking to everyday challenges, identifying and resolving problems at the point of care rather than waiting for them to escalate.
About the Conference Presentation
Together We Care 2026
Ontario Long Term Care Association
Beyond Pilot Projects: Harnessing Lean Leaders to Build a Culture of Continuous Quality Improvement
Kindera™ Living and Leading Edge Associates presented this transformation journey at Together We Care 2026, the Ontario Long Term Care Association conference, in a session titled "Beyond Pilot Projects: Harnessing Lean Leaders to Build a Culture of Continuous Quality Improvement."
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Where to go next
Bring Lean to your long-term care organization
The Kindera™ Living experience demonstrates that sustainable quality improvement in long-term care requires more than pilot projects. It requires investing in people, building internal leadership capability, and embedding continuous improvement into the fabric of daily operations.
Leading Edge Associates offers Lean Healthcare training and consulting tailored for long-term care organizations, including Green Belt certification and project leadership, along with quality improvement coaching for leadership teams.
Interested in building a culture of continuous improvement in your long-term care organization?
Get in touch with our team