Virginia Mason’s Improvement Cited in NYT Editorial; Their New Blog


Virginia Mason Medical Center, a world-renowned leader in the application of Lean principles in healthcare, has a new blog: Virginia Mason Blog. They name blogs the way I do, simple and direct :-)

One of their first posts highlights a Sunday New York Times editorial that talks about some good news stories of healthcare organizations that are performing far beyond the norm – Virginia Mason being one of them.

The piece, “Treating You Better for Less,” unfortunately doesn't mention Lean or the Toyota Production System (ala the “Virginia Mason Production System”) that is VMMC's main improvement model and management system. But, the Times does a good job of summarizing what is possible with Lean in healthcare.

From the Times:

In Seattle, the Virginia Mason Medical Center, once deemed a high-cost provider, has conducted rigorous internal reviews to eliminate waste and inefficiency. It says that after doctors were required to click through a computerized checklist of the medical circumstances needed to justify a costly imaging test, CT scans for sinus conditions dropped by 27 percent and M.R.I.'s for headaches by 23 percent. It placed nursing teams and supplies closer to patients, freeing nurses to spend 90 percent of their time on direct patient care, far more than the 35 percent at most hospitals. The time needed to process insurance claims was sharply cut by consolidating steps. In a tough environment for hospitals, Virginia Mason has been reporting margins of 4 to 5 percent.

VMMC has been working to deliver higher-quality, more consistent care that costs less. It's great to see them get more recognition.

The article also cites Cincinnati Children's, which uses Lean and Six Sigma as part of their broader quality improvement efforts.

The Times also cites a:

forthcoming report from the Institute of Medicine, in which the chief executives of 11 health care systems endorse a checklist of 10 steps they say every hospital can take to reduce costs and improve care.

I'm curious to see this checklist (update: here is the link to the PDF doc from the IOM). There's no easy quick list of 10 things you have to do to completely overhaul your organization. These 10 things might be good “best practices” worth adopting (like using checklists to help prevent surgical errors). But, haven't hospitals been copying and adopting best practices for a long time?

Just ask organizations like Virginia Mason, ThedaCare, University of Michigan Health System… the sort of culture change required to TRULY transform an organization with Lean takes time and a lot of hard work. Has anyone seen a preview of the IOM report? Will these practices be embraced and spread more quickly than checklists for central lines, surgery, etc.?

I was able to interview some people at Virginia Mason for my new book, Healthcare Kaizen, that is due out this month.

From Healthcare Kaizen:

While receiving less publicity than the RPIWs, Virginia Mason has also used an approach to daily Kaizen called the “Everyday Lean Idea” (ELI) program. This program was started in 2005, while RPIWs were being started and before the formal VMPS name was adopted. The approaches work together, as Jennifer Phillips, innovation director said, “We have a range of improvement systems, but ELI is designed for small problems. It's not the only method and neither is RPIW.” She added, “We're getting better at triaging problems to the right approach” as issues arise.

VMMC is famous for their week-long RPIWs… but they are also using small daily Kaizen in parallel, as many organizations are doing these days.

Some of the early VMMC blog posts (written by the excellent writer, Charles Kenney, who did  the book about Lean at VMMC):

Check out the great content there. I know I'll be a regular reader.

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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.


  1. The article also mentions “a recent book published by the Institute for Health Care Improvement” without actually citing the book. It’s Pursuing the Triple Aim: Seven Innovators Show the Way to Better Care, Better Health, and Lower Cost.


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