By August 16, 2009 0 Comments Read More →

Denver Health’s CEO Spreading the Word about Lean

Checking In With Denver Health CEO Patricia Gabow On A “Model” Health Care System – Kaiser Health News

Dr. Patty Gabow has been one of the leading CEO voices talking about Lean in Healthcare, as shown in the article linked above and in her June 25th testimony to Congress, she said:

As stated in the Health Care Reform Draft Proposal, costs must be reduced. This is necessary if we are to cover everyone. Costs can be reduced by getting patients to the right place, at the right time, with the right level of care, with the right provider, with the right outcomes and the right financial incentives. This is not a theoretical construct. For example, our charges per Medicaid day and per Medicaid admission are thirty-two percent below our peer Colorado metropolitan hospitals.


Waste can be removed from our health care delivery systems. Denver Health has adopted Toyota Production Systems or “LEAN” to improve quality by removing waste in all components of our health care system. We have extensively trained 170 employees, including physicians and nurses, in LEAN tools and have realized more than $25 million in financial benefit in less than three years. There are numerous ways to reduce health care costs in our health system without reducing quality. In fact, quality can be enhanced.

Better quality AND lower cost. Great news for healthcare. These improvements are real, they just aren’t widespread enough yet.

A favorite expression at MIT is attributed to the author William Gibson, who said:

The future is already here – it is just unevenly distributed.


The same can be said about healthcare. Although not directly referencing Lean, the New York Times op-ed piece by Dr. Atul Gawande and Paul O’Neill (with others) makes the case that we already have high-performing hospitals – there just aren’t enough of them.

Public data shows that the top performing cities are:

Asheville, N.C.; Cedar Rapids, Iowa; Everett, Wash.; La Crosse, Wis.; Portland, Me.; Richmond, Va.; Sacramento; Sayre, Pa.; Temple, Tex.; and Tallahassee, Fla.


These are hardly the big name medical center towns that tend to dominate the U.S. News rankings of who has the best reputation. Instead, look for performance. La Crosse WI is a town that John Toussaint has sung the praises of, as well.

Gawande, et. al., say:

If the rest of America could achieve the performances of regions like these, our health care cost crisis would be over. Their quality scores are well above average. Yet they spend more than $1,500 (16 percent) less per Medicare patient than the national average and have a slower real annual growth rate (3 percent versus 3.5 percent nationwide).


They add:

We must instead look at the communities that are already redesigning American health care for the better, and pursue ways for the nation to follow their lead.


Gundersen Lutheran is part of our Healthcare Value Leaders Network, a collaborative between the Lean Enterprise Institute and the ThedaCare Center for Healthcare Value. Gundersen Lutheran uses the Lean methodology and they, like the other network members, are working hard to share their practices and methods with other hospitals in and out of the network. ThedaCare has used Lean thinking to redesign their primary model (Collaborative Care) to provide better quality and lower cost.

Better healthcare futures are already out there. But we need more of it. We’re hoping Denver Health and other leading healthcare organizations will be part of future networks.

p.s. Denver Health is one of many organizations listed on my “Lean Healthcare Map” that can be accessed via www.leanmaps.com. Feel free to help us build out this map with references to articles that document their Lean efforts (using the process I described here). You can access more success stories via the Resources area of our Healthcare Value Leaders Network site including another article about Denver Health.


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Mark Graban's passion is creating a better, safer, more cost effective healthcare system for patients and better workplaces for all. Mark is a consultant, author, and speaker in the "Lean healthcare" methodology. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. His most recent project is an eBook titled Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also the VP of Improvement & Innovation Services for the technology company KaiNexus.

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