“Lean ROI” Interview with Virginia Mason CEO, Gary Kaplan, M.D.


Those who follow Lean healthcare know that Virginia Mason Medical Center, in Seattle, is one of the world's leaders in improving care through Lean methods. They were featured last year on the CBS Evening News, for example.

The LeanROI.org site, the same one that earlier featured a six-part interview with ThedaCare's Dr. John Toussaint, now has an interview series with the CEO of Virginia Mason, Dr. Gary Kaplan.

You can find links to all four parts here or I'll share the individual links below, with some brief comments.

1) Long- and Short-term ROI

While the study being done on the site is about ROI, Kaplan rightfully points out that it's about much more than ROI, including quality and safety primarily. That said, he adds:

For us the ROI question wasn't front burner, but I will tell you, I believe that the ROI from this investment is greater than from any other investment we've ever made…

VMMC has reduced costs through better quality and by not needing as much capital expansion or staff increases to keep up with growing demand. It's good for the patients and the organization… and staff satisfaction is higher.

2) Getting Started

Kaplan says he avoids the word “Lean” for the negative connotations that can come with it and, until two months ago, liked to reference Toyota.

I admire his willingness to admit problems, including:

Our board asked us, “Who is your customer?” Like everybody in healthcare, we said, “The patient.” And they said, “Time out. If that were really the case, why do things look the way they do?” And as we looked at the way things looked – we were quite typical for healthcare – everything was designed around the doctors and the nurses and the managers and all of the people who work in healthcare, and not really around the patient.

Kaplan talks about learning from Boeing and Wiremold, among manufacturers. They have also been aggressive about sending teams to Japan (they are on their 12th trip). I have mixed feelings about that — you?

3) Lean Is a Management System

Kaplan emphasizes that, at VMMC, Lean is not just a quality improvement or process improvement system — it's a management system.

It's how we run our entire organization; whether it's the finance department, the IT department, the critical care unit, inpatient services, or primary care. It's a management system.

He emphasizes the role of leadership and the practice of leadership, including leadership standard work and the hoshin kanri / strategy deployment process. Leading in a lean way is an expectation at VMMC.

4) Leadership

Kaplan focuses on leadership and thinking differently:

We've learned – I've personally learned – to lead in different ways. I've also learned to think differently

My view is that the evolution in thinking doesn't happen over night. In an earlier section, Kaplan talks about how important it is to learn the tools of Lean/TPS through kaizen events. Use of tools, while not entirely sufficient, is a reasonable step toward learning how to think differently. Act your way to a new way of thinking, as they say.

As CEO, Kaplan has learned to be visible and involved. I've seen previous quotes where he talks about walking the hospital every day, looking for waste and improvement opportunities. That's outstanding.

He says:

What I do is work on taking out waste, improving quality and safety at every opportunity. I'm much more focused on that. I'm making sure we have staff engagement to allow that to happen, and focus on execution and results. While those are all things that conventional leaders do, lean has given us a method by which to focus.

Thanks to David Drickhamer, who I met at the recent LEI Lean Transformation Summit, for putting this interview series together. Follow him on Twitter as @leanroi.


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Mark Graban is an internationally-recognized consultant, author, and professional speaker who has worked in healthcare, manufacturing, and startups. His latest book is Measures of Success: React Less, Lead Better, Improve More. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. He also published the anthology Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also a Senior Advisor to the technology company KaiNexus.

  1. mjh81 says


    There’s also this interview with Dr. Kim Pittenger, Medical Director at VM Kirkland Clinc. Very interesting stuff.

  2. […] An interview with Dr. Kaplan (via LeanROI.org) […]

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