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This book gives the reader an inside look at creating a new healthcare service using practical examples and scenarios one would face if doing it themselves. This book chronicles the journey of a fictitious healthcare delivery organization using the Simpler Design System principles based on Lean methodologies. While the characters and actual story is fictitious, it is based on the journey many healthcare systems and clients have taken, the issues they have faced, and the successes and failures they’ve had. Tools and approaches used are based on the actual work of Simpler. The story format engages readers and is intended to motivate and inspire executive teams to use the tenets of the book as a guide to launch their own successful implementation of an idea-to-launch methodology. Tools include those gleaned from actual application of Lean Product Development, Agile, Design for Six Sigma, and Design Thinking Principles. Through engaging storytelling and practical theory, this book is written from the perspective of a physician leader that agrees to be the executive sponsor for a service redesign. As the story progresses, the sponsor becomes fascinated with the process and becomes the first VP of Innovation within his organization.
The book shows readers exactly how to use Lean tools to design healthcare work that is smooth, efficient, error free and focused on patients and patient outcomes. It includes in-depth discussions of every important Lean tool, including value stream maps, takt time, spaghetti diagrams, workcell design, 5S, SMED, A3, Kanban, Kaizen and many more, all presented in the context of healthcare. For example, the book explains the importance of quick operating room or exam room changeovers and shows the reader specific methods for drastically reducing changeover time. Readers will learn to create healthcare value streams where workflows are based on the pull of customer/patient demand. The book also presents a variety of ways to continue improving after initial Lean successes. Methods for finding the root causes of problems and implementing effective solutions are described and demonstrated. The approach taught here is based on the Toyota Production System, which has been adopted worldwide by healthcare organizations for use in clinical, non-clinical and administrative areas.
Instead of building new hospitals that import old systems and problems, the time has come to reexamine many of our ideas about what a hospital should be. Can a building foster continuous improvement? How can we design it to be flexible and useful well into the future? How can we do more with less? Winner of a 2013 Shingo Prize for Operational Excellence! Answering these questions and more, Lean-Led Hospital Design: Creating the Efficient Hospital of the Future explains how hospitals can be built to increase patient safety and reduce wait times while eliminating waste, lowering costs, and easing some of healthcare’s most persistent problems. It supplies a simplified timeline of architectural planning—from start to finish—to guide readers through the various stages of the Lean design development philosophy, including Lean architectural design and Lean work design. It includes examples from several real healthcare facility design and construction projects, as well as interviews with hospital leaders and architects. Check out a video of the authors discussing their book, Lean-Led Hospital Design at the 2012 Med Assets Healthcare Business Summit. www.modernhealthcare.com/section/LiveatHBS
A growing, aging population; the rise to epidemic proportions of various chronic diseases; competing, often overlapping medical technologies; and of course, skyrocketing costs compounded by waste and inefficiency - these are just a few of the multifarious challenges currently facing healthcare delivery. An unexpected source of solutions is being imported from the manufacturing sector: lean thinking. Lean Principles for Healthcare presents a conceptual framework, management principles, and practical tools for professionals tasked with designing and implementing modern, streamlined healthcare systems or overhauling faulty ones. Focusing on core components such as knowledge management, e-health, patient-centeredness, and collaborative care, chapters illustrate lean concepts in action across specialties (as diverse as nursing, urology, and emergency care) and around the globe. Extended case examples show health systems responding to consumer needs and provider realities with equal efficiency and effectiveness, and improved quality and patient outcomes. Further, contributors tackle the gamut of technological, medical, cultural, and business issues, among them: Initiatives of service-oriented architecture towards performance improvement Adapted lean thinking for emergency departments Lean thinking in dementia care through smart assistive technology Supporting preventive healthcare with persuasive services Value stream mapping for lean healthcare A technology mediated solution to reduce healthcare disparities Geared toward both how lean ideas can be carried out and how they are being used successfully in the real world, Lean Principles for Healthcare not only brings expert knowledge to healthcare managers and health services researchers but to all who have an interest in superior healthcare delivery.
Every healthcare organization can learn from Seattle Children‘s continuous improvement process, but this book is not an operator‘s manual. Instead, it is a challenge to everyone concerned with healthcare to reexamine deeply held assumptions. While it is commonly believed that improved quality, access, and safety, and an improved bottom line are mut
Organizations around the world are using Lean to redesign care and improve processes in a way that achieves and sustains meaningful results for patients, staff, physicians, and health systems. Lean Hospitals, Third Edition explains how to use the Lean methodology and mindsets to improve safety, quality, access, and morale while reducing costs, increasing capacity, and strengthening the long-term bottom line. This updated edition of a Shingo Research Award recipient begins with an overview of Lean methods. It explains how Lean practices can help reduce various frustrations for caregivers, prevent delays and harm for patients, and improve the long-term health of your organization. The second edition of this book presented new material on identifying waste, A3 problem solving, engaging employees in continuous improvement, and strategy deployment. This third edition adds new sections on structured Lean problem solving methods (including Toyota Kata), Lean Design, and other topics. Additional examples, case studies, and explanations are also included throughout the book. Mark Graban is also the co-author, with Joe Swartz, of the book Healthcare Kaizen: Engaging Frontline Staff in Sustainable Continuous Improvements, which is also a Shingo Research Award recipient. Mark and Joe also wrote The Executive’s Guide to Healthcare Kaizen.
Accelerating Health Care Transformation with Lean and Innovation: The Virginia Mason Experience describes how Virginia Mason Medical Center (VMMC) has systematically integrated innovative structures, methods, and cultural practices into its implementation of Lean. Describing how an organization can create a strategy and build a culture of innovation and learning, it supplies concrete examples that show how Lean and innovation can work hand-in-hand to improve and transform value streams. It also explains how to use the voices of patients and their families to drive improvement and innovation.
Hospitals have long relied on the heroics of one brilliant nurse or doctor to save the day. Such heroics often result in temporary workarounds and quick fixes that leave not only patients and quality care at risk, but also increase costs. This is the story of an organization breaking that habit. Like a growing number of healthcare organizations around the world, ThedaCare, Inc. has been using lean thinking and the principles of the Toyota Production System to improve quality of care, reduce waste, and become more reliable. But lean thinking was incompatible with ThedaCare’s old top-down, hero-based system of management. Kim Barnas, former SVP of ThedaCare, shows us how she and her team created a management system that is stable and lean, to spur continuous improvement. Beyond Heroes shows the reader, step by step, how ThedaCare teams developed the system, using the stories of its doctors, nurses and administrators to illustrate. The book explores each of the eight essential components of the lean system, from front-line problem solving with the scientific method to daily team huddles and creating standard work for leaders all the way to the top of an organization. Finally, the author introduces four executives from healthcare systems across North America who have implemented ThedaCare’s system and share the lessons they learned along the way. Beyond Heroes is not just a call to action or an argument for a better healthcare system. It is a necessary roadmap through the rocky terrain ahead, one that healthcare leaders can customize to their special needs.
It has been almost 20 years since the Institute of Medicine released the seminal report titled, Crossing the Quality Chasm. In it, the IoM identified six domains of care quality (safe, timely, effective, efficient, equitable, and patient-centric) and noted a huge gap between the current state and the desired state. Although this report received a great deal of attention, sadly there has been little progress in these areas. In the U.S., healthcare still has huge disparities, is inefficient, and is fragmented with delays in care that are often unsafe. Most U.S. citizens are expected to suffer from a diagnostic error sometime during their lifetime, not receive a large fraction of recommended care, and pay for one of the most expensive systems in the world. Much has been written about quality improvement over the years but many prominent quality and safety experts. Yet progress has been slow. Some have called on the healthcare professions to look outside of healthcare to other industries using examples in nuclear power and airlines for safety, the hotel and entertainment industry for a ‘customer’ focus, and the automotive industry, particularly Toyota for efficiency (Lean). This book by Dr. Oppenheim on lean healthcare systems engineering (LHSE) is a fresh approach that brings forth concepts that systems engineers have used in huge national defense projects. What’s unique in this book is that these powerful system engineering tools are modified to be able to address smaller sized healthcare problems that still involve similar problems in fragmentation and poor communication and coordination. This book is an invaluable reference for a new powerful process named Lean Healthcare Systems Engineering (LHSE) for managing workflow and care improvement projects in all clinical environments. The book applies to ambulatory clinics and hospitals of all types including operating rooms, emergency departments, and ancillary departments, clinical and imaging laboratories, pharmacies, and population health. The book presents a generic rigorous but not mathematical step-by-step process of integrated healthcare, systems engineering and Lean. The book also contains the first major product created with the LHSE process, namely tabularized summaries of representative projects in healthcare delivery applications, called Lean Enablers for Healthcare Projects. Each full-page enabler table lists the challenges and wastes, powerful improvement goals, risks, and expected benefits, and some useful descriptions of the healthcare system of interest. The book provides user-friendly solutions to major problems in healthcare delivery operations in all clinical environments, addressing fragmentation, wastes, wrong incentives, ad-hoc and stove-piped management, lack of optimized processes, hierarchy gradient, lack of systems thinking, “blaming and shaming culture”, burnout of providers and many others.
Part case study, part manifesto, this groundbreaking new book by a doctor and a healthcare executive uses real-life anecdotes and the logic of lean thinking to make a convincing argument that a revolutionary new kind of healthcare -- lean healthcare -- is urgently needed and eminently doable. In On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry John Toussaint, MD, former CEO of ThedaCare, and Roger A. Gerard, PhD, its chief learning officer, candidly describe the triumphs and stumbles of a seven-year journey to lean healthcare, an effort that continues today and that has slashed medical errors, improved patient outcomes, raised staff morale, and saved $27 million dollars in costs without layoffs. Find out: * How lean techniques of value-stream-mapping and rapid improvement events cut the average "door-to-balloon" time for heart attack patients at two hospitals from 90 minutes to 37. * What ThedaCare leaders did to replace medicine's "shame and blame" culture with a lean culture based on continuous improvement and respect for people. * How the lean principle of "building in quality at the source" broke down divisions among medical specialties allowing teams to develop patient care plans faster. * Why traditional modern management is the single biggest impediment to lean healthcare. * How the plan-do-study-act cycle coupled with rapid improvement events cut the wait time at a robotic radiosurgery unit from 26 days to six. * How the lean concept of "one piece flow" saved time in treating ischemic stroke patients, increasing the number of patients receiving a CT scan within 25 minutes from 51% to 89%. * How senior leaders at other healthcare organizations can begin their own lean transformations using a nine-step action plan based on what ThedaCare did -- and what it would do differently. Toussaint and Gerard prove that lean healthcare does not mean less care. On the Mend shows that when care is truly re-de