I Sometimes Sort of Hate My Book’s Title, I Think
Another interesting discussion that came up during my trip to The Netherlands… my book's title: Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction (see the 2016 3rd edition).
I'd have to admit, the phrase “Lean Hospital” is a tough description to live up to. The term “lean” originally referred to the performance gap between auto plants run under the Toyota/lean system and those run the traditional way. To be “lean” meant that your plant was significantly better in many regards – not 5% better but 50% better: quality, labor productivity, etc.
Are there hospitals that are uniformly 50% better than the standard benchmark? Probably not… yet. Maybe some are getting there, but it will still take time. To be a “Lean Hospital,” does that mean half the infection rates, half the preventable mortality rates, twice the nursing labor productivity, etc.? Is that possible?
We have to be careful that “Lean” doesn't mean “perfect.” Lean is not a destination, a point we reach where we get a flag to fly out in front of the hospital. If Lean meant perfect, then nobody is lean, including Toyota, since everybody has waste.
Ultimately, “Lean Hospitals” was meant to be a snappy short title. A more accurate title might have been:
“Hospitals That Are Using The Lean Methodology in a Significant Way.”
More accurate, but probably not a better title.
Then, there's the discussion about the subtitle. Where does long-term financial performance enter into the picture? Is this not important? Toyota says the goal of TPS is long-term corporate vitality, as they put it. Long-term vitality is important for a hospital… have to not lose tons of money, have to keep the doors open.
So maybe a better subtitle is:
“Achieving Long-Term Hospital Financial Vitality through Continuously Improving Quality, Patient Safety, and Employee Satisfaction, Amongst Other Important Goals.”
Nah, it's probably better the way it is… what would you call it?