Saskatchewan’s Health Care System and “Lean” What is the Lean Management System? Lean is a philosophy or a mindset-a patient-focused approach to reducing waste by identifying and eliminating activities that do not add value.Value-adding activities are those that the patient or client is willing to pay for.askatchewan is uniquely positioned to introduce major, meaningful health care reform. Health regions, health care professionals and associations, unions health sector agencies and other partners are ready to commit to an aggressive four-year program.