Dr. Jack Billi, University of Michigan Professor, on Applications of Lean for Medicine and Physicians



Episode #110 is a chat with Dr. Jack Billi from the University of Michigan Health System and Medical School.

Here, we talk about their lean work and how Dr. Billi works with physicians to engage them in lean, tying lean problem solving methods, including the A3 approach, to the scientific method and medical thinking. Dr. Billi talks about the right approach to the lean concept of “standardized work” in a way that works for medicine and complex patient situations.

More about Dr. Billi,  Associate Dean for Clinical Affairs, Medical School and Associate Vice President, Medical Affairs:

Dr. Billi is Professor of Internal Medicine and Medical Education. He leads the Michigan Quality System, the University of Michigan Health System's unified approach to improve quality, safety, efficiency, appropriateness and service using lean tools and philosophy. Dr. Billi's research and leadership interests are in health services delivery and the use of community consortia for quality improvement. He is active on statewide and regional groups affecting quality of care, pay-for-performance and public reporting. He chairs the Michigan State Medical Society's Committee on Quality, Efficiency and Economics and the Essential Benefit Design Work Group and is a member of MSMS's Board of Directors. Dr. Billi co-chairs the Medical Director Committee for the Michigan Quality Improvement Consortium which develops and disseminates evidence-based practice guidelines used by Blue Cross Blue Shield of Michigan and 15 other health plans representing over six million members.

To point others to this episode, use the simple URL:  www.leanblog.org/110.

For earlier episodes, visit the  main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

If you have feedback on the podcast, or any questions for me or my guests, you can email me at leanpodcast@gmail.com or you can call and leave a voicemail by calling the “Lean Line” at (817) 993-0630 or contact me via Skype id “mgraban”. Please give your location and your first name. Any comments (email or voicemail) might be used in follow ups to the podcast.

Partial Transcript:

Jack, I want to thank you for taking time out of your day and your busy schedule to talk today. Thanks for joining us.

Dr. Jack Billi: I'm really delighted to be here. I've learned a lot through working with the Healthcare Value Leaders Network and the work that you've done, so I'm delighted to chat.

Mark: Thanks, and it's a pleasure to have you as part of the network and here today, so I'm wondering if you could start by introducing yourself to the listeners who you are, what your roles are there at the university.

Dr. Billi: Sure, my name is Jack Billi, I'm a general internist. I've been at the university for 33 years. I've spent a lot of that time as Associate Dean for Clinical Affairs in the medical school. I also have a role in the health system to complement that.

My most important work for the last five years has been what might be called the chief engineer or the senior deployment leader for the Lean transformation for the University of Michigan Health System.

Mark: I'm curious also, in terms of introductions, from your career as a physician and a leader in the university and the health system, what was your first exposure to Lean?

You're there in Michigan. You have the auto industry. You've got a lot of well-known Lean people within the university. Where did your first exposure come to? Maybe share, if you can, some of your initial reactions to Lean from your medical background.

Dr. Billi: I've been involved in problem solving in various administrative roles for the central administration of the health system for many years, but had no formal model or role. It was about seven years ago that Gary Kaplan, the CEO of Virginia Mason who's an alumni of the university of Michigan, was invited in to give a talk about the use of Lean thinking at Virginia Mason.

That captivated me. I went to dinner with him that night and we walked across the street to Border's Bookstore. I bought a copy of “Lean Thinking” by Jim Womack. I have never looked back since that time.

It made so much sense to me to try and bring a much more comprehensive model to our problem solving, instead of having people all using their own home grown intuitive models, some really not very robust for solving problems.

It made a lot of sense for us to pick a consistent problem solving model across the health system. We've been working on that pretty intently for the last five years.

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.



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