After this first pilot in 2006, the makigami methodology was soon being used by one of the team members (a nurse) to improve other processes.
The same happened in the Radboud Medical Centre. After a first makigami performed in the ER of the University Hospital (in Nijmegen, the Netherlands), one of the staff members used it in other departments and later in other hospitals.
Today it has also successfully been implemented in other medical disciplines.
Where expensive equipment is being used -like MRI scanners, gamma knives or other radio-therapy equipment- the combination of makigami and OEE (see oeefoundation.org) will show spectacular results!