In their quest for efficiency, some Central Massachusetts hospitals are following in the steps of an industry that could not seem more different: manufacturing.

Medical administrators are running Lean or Six Sigma initiatives in Worcester and other locations, using management techniques long associated with automakers to ferret out waste and maybe save money.

Its an arduous process, openly dismissed by a large nurses union and frequently unsuccessful, according to experts. Yet some administrators say it could prove critical to hospitals as employers, insurers and government push to control medical spending.

Theres always something new to get at. Theres always more waste, said Dr. Charles E. Cavagnaro, president and chief executive of Wing Memorial Hospital, a 74-bed hospital in Palmer that is part of the Worcester-based UMass Memorial Health Care system. Will it get expense out? I believe so.

Lean and Six Sigma refer to methods of improving work processes. Lean typically involves identifying the steps used to bring a product or service to a customer and then eliminating those steps that do not add value. Lean is associated with production innovations at Japanese automaker Toyota Motor Corp., which encouraged kaizen, or improvement.

Six Sigma was developed by electronics maker Motorola Inc. in the 1980s to reduce variations in manufacturing that lead to defective products. Experts in Six Sigma earn black belt or green belt distinctions.

Chip Caldwell, president of the St. Augustine, Fla., consulting firm Caldwell Butler & Associates, estimates that 50 percent to 60 percent of U.S. hospital and health care systems have launched Lean or Six Sigma initiatives, up from about 10 percent just five years ago. Thats partly because health care administration is a small industry in which individuals hear or read about others initiatives, he said, but also because of financial pressures.

Everyone is expecting reimbursements to drop dramatically, said Mr. Caldwell, who sits on the American Society for Qualitys health care panel. More people will be insured, he said, but theyre going to be insured at the Medicare rate, which at todays rates is an 11 percent loss in the average U.S. hospital.

Launching Lean or Six Sigma is no simple task. Dr. Cavagnaro prepared by taking an online course from Villanova University, then in mid-2011 visited ThedaCare, a community hospital system in northeastern Wisconsin known nationally for its Lean efforts. Since then, Dr. Cavagnaro said, Wing Memorial Hospital started a process improvement department with three Lean black belt experts. He also took about 25 hospital staffers to ThedaCare in June for a two-day symposium.

One Lean effort at Wing Memorial that involved separating patients in the emergency department so some flow faster to care has already reduced patient waiting times by more than 5 percent, he said. Another focusing on billing for radiology procedures has reduced denials from insurers by more than 80 percent and brought additional payments to the hospital, he said.

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'Lean' approach to health care