Tag: Virginia Mason
I saw this headline the other day: “U.S. Soldiers Get Just Four Hours of Ebola Training”
The phrase “just four hours” implies that it wasn’t enough. How do we know? Maybe four hours of training, done properly, is all that’s needed.
There are certainly many serious problems in healthcare. Let’s look at nursing, in particular. It’s a rewarding job, but it’s far more frustrating for nurses than it needs to be.
Nurses often don’t have enough time in the day (or in a given hour) to do all of their work the right way in the time available. I’ve worked with nurses who listed out all of the tasks they were supposed to do in an hour, from rounding on patients, giving medications, etc. and it added up to 80 minutes worth of work to be done in 60 minutes.
There have been plenty of headlines and updates since I first blogged about the controversy over Lean healthcare in the Canadian province of Saskatchewan (see my previous posts here).
From my outside perspective, there are some good things happening. I admire their adoption of a “patient safety alert system” and a blame-free culture (see Saskatoon Health Region CEO Maura Davies’ comment about this on a recent post of mine).
If you clicked on my intentionally attention grabbing headline (or what might be a parody of those)… no, Toyota isn’t killing their famed and much-copied Andon process.
Toyota is just changing the mechanics of the Andon system – or perhaps improving it… in the spirit of Kaizen, or continuous improvement.
I recently saw a tweet that referenced a May 2014 that was sent to President Obama and his administration: “Report to the President – Better HealthCare and Lower Costs: Accelerating Improvement Through Systems Engineering.”
MP3 File (run time 34:37)
Joining me today for Episode #204 is Paul Plsek (@PaulPlsek) and we’re talking about his excellent book (a Shingo Research Award recipient this year) titled Accelerating Health Care Transformation with Lean and Innovation: The Virginia Mason Experience. Virginia Mason, of course, is Virginia Mason Medical Center, the outstanding Lean organization that was named “Hospital of the Decade” by Leapfrog Group.
MP3 File (run time 34:56)
My guest today for Episode 202 is Patrick Graupp, co-author of the excellent book Getting to Standard Work in Health Care: Using TWI to Create a Foundation for Quality Care, co-authored with Martha Purrier from Virginia Mason Medical Center. If you’re brand new to the Training Within Industry (TWI) model, you might want to first listen to Episode 196, with Jim Huntzinger, on “What is TWI?“
I recently saw an article about Avera Medical Group and Sanford Clinic in Sioux Falls, South Dakota: “Health systems learn to be lean.” Avera McKennan Hospital, in Sioux Falls, was featured in the 2nd edition of my book Lean Hospitals.
I didn’t know , until yesterday, that Toyota has an official company blog (at least for Toyota UK).
Even though I’ve learned from Toyota people and many books and classes (and I’ve written books of my own), I always encourage people to get Toyota Production System knowledge directly from the source whenever possible – including the books of Ohno & Shingo and modern-day Toyota people like Pascal Dennis, David Meier, John Shook, and others).
Toyota has a post about 13 “pillars” (principles, really?) of the Toyota Production System. Check it out.
Since the healthcare improvement work I do is apolitical and non-partisan, I’m generally not one to butt into the political affairs of Canada or other countries. But, when I hear complaints about Lean or when it’s being called a “scam” and a “cult” by some in Saskatchewan (read here), my ears perked up and I started talking with some folks up there. My goal isn’t to blindly defend Lean, but to first understand, but also trying to clarify myths or misunderstandings where I can.
I’ve had some contentious discussions (a union president who arrogantly replied, “No, I’m good” when I offered to send links to medical journal articles about Lean), but also some lovely chats via Twitter and email. Yesterday, I had a long and interesting phone call with Murray Mandryk, a political columnist for the Regina Leader-Post. He apologized repeatedly (as polite Canadians do) for “dragging me into” this political fight of theirs. I told him that it was, if anything, my fault for diving in.
The start of the article:
After some supporters of the Saskatchewan Lean healthcare efforts reached out to me, I’ve been trying to follow everything that’s being said and written – which is hard to do (just try a Google news search). There are many facets to this story, some of which are discussed well by John Shook and Bill Waddell in their blog posts.
Somebody from Saskatchewan complained to me via email that “Lean’s gotten political.” Hmm… government-run healthcare system with elected politicians (and elected union officials to boot), it’s always political. The rooster crows when the sun comes up, the politician gets political. No surprise.
I recently stumbled across a very interesting and well-produced mixed-media presentation that starts with the sounds of snow crackling under a pair a boots… a video clip that illustrates Delvecchio Finley, the CEO of Harbor-UCLA Medical Center, making a snowy trip to ThedaCare, in Appleton, Wisconsin to learn about Lean and healthcare improvement.
Check out the presentation by Russell Mitchell here. Make sure you are at a computer with speakers or headphones. You might want to view it in a conference room with a team to be able to discuss it.
They introduce a pretty good definition of Lean at the start:
“Lean is a bottom-up approach to identifying and fixing broken systems–for example, a medication delivery system responsible for high rates of hospital errors, or a patient intake process that produces long backlogs and waiting times that muck up schedules and frustrate patients. “Bottom up” means that Lean relies on people closest to the work to fix systemic problems.”
They just started a year ago (better late than never?), but San Francisco General Hospital had its Lean efforts highlighted in the San Francisco Chronicle last week: “S.F. General following ‘Toyota Way’ to efficiency.”
On the very same day, another headline flew past about a patient who had wandered off and gotten lost in the hospital (a so-called “never event“), with her body being found in a hospital stairwell: “Body Found at San Francisco General Hospital Is Missing Woman Lynne Spalding.”
The way the hospital reacts to this sad, unfortunate event might be a real test of whether they are adopting a true “Lean Culture” or if they are just running a bunch of “Kaizen Events.”
The year is 1981. A Major League Baseball strike interrupts the season. We’re in the midst of the Cold War. President Reagan is shot. Kim Carnes’ (not to be confused with ThedaCare’s Kim Barnas) tops the charts for the year with “Bette Davis Eyes.” And, Toyota has zero manufacturing presence in the United States… yet.
What became known as “Lean” in 1988 (25 years ago, I’ll be blogging about this soon), was exotic enough to be referred to commonly as “Japanese manufacturing practices,” as evidenced by a brilliant and prescient HBR article by Prof. Robert B. Hayes: “Why Japanese factories work.” But, the things that set some Japanese factories apart were really just good, solid, fundamental management practices.
Joe Swartz and I are happy to say that The Executive Guide to Healthcare Kaizen should be available in the next week or so (via in paperback via our publisher, CRC Press or Amazon, Kindle format, and PDF). Learn more about the book, pre-order, or learn more about the differences between this edition and the original book (which will still be available). Update: the book is out of “pre-order” status at CRCpress.com and Amazon.
We were thrilled that Gary Kaplan, CEO of Virginia Mason Medical Center, would write a new introduction for this edition, printed below.
I was fortunate to be exposed to the writings of W. Edwards Deming before I even learned about Lean. While I sometimes get tired of reading new books on Lean and Toyota, I never tire of revisiting books by or videos featuring Dr. Deming. A few years back, I again re-read big chunks of “Out of the Crisis” and blogged about it here and here.
There’s a timeless wisdom in what he said – and we’re reminded of his work when exposed to people like my podcast guests Alfie Kohn, Dan Pink, Mike Micklewright, Samuel Culbert, Clare Crawford-Mason, Mike Stoecklein, and John Hunter.
We get to revisit Deming’s wisdom in the recently published book “The Essential Deming: Leadership Principles from the Father of Quality.”
Stuff I’m Reading – June 14, 2013: Sleepy Banker, Concerned Workers, Cost Diversity, Conference Diversity
It’s again time to close some browser tabs and clear out the backlog of articles I’ve wanted to share but maybe don’t merit an entire blog post…
It’s time again for “Stuff I’m Reading”… Click on any header for the article I’m referencing.
A banker fell asleep on his keyboard, in particular the “2” key, entering a transfer of 222,222,222.22 euros. A colleague was fired for not double-checking or confirming the error. That’s why it’s called “human error” – many types of human error involved in this case.
I had a chance to attend the Lean Kanban North America conference this week. It was a different “tribe” to be a part of, as the topics focused on software and IT settings, including agile development, “kanban” project management, and broader lean management topics.
I gave a talk on “lean healthcare,” which is always an interesting challenge when it’s not an audience of healthcare professionals.
Here are notes and links that I cited in my slides, including data and key references: