Dr. Gary Kaplan’s Piece on Lean for the Institute of Medicine
Here is a commentary written by Gary S. Kaplan, MD, the CEO of Virginia Mason Medical Center: “The Lean Approach to Health Care: Safety, Quality, and Cost.”
More than a decade ago, Kaplan and the team at VMMC realized they had to focus “on three things: 1) the safety of patients while in our care; 2) the quality of the care we provided; and 3) the cost of delivering care.”
Their approach for this?
We found the necessary tools in the Toyota Production System (TPS). TPS is often referred to as a “Lean” management method, because it focuses on reducing waste while improving quality. We call our version the Virginia Mason Production System, or VMPS.
It's not just about “tools” – it's about the culture and a system for daily management and improvement at VMMC.
Learning to use VMPS consistently and effectively is part of changing the culture and takes many years. This is really not unexpected. A Lean system like VMPS re-quires deep organizational changes â€” changes that challenge long-held beliefs and accepted practices. Our results have been gratifying and propel us to work even harder to deploy these methods and tools deeply within our organization.
Kaplan outlines some examples of their improvements in areas ranging from nursing to the improved management of chronic diseases.
Steps walked per day fell from 10,000 to roughly 1,200. The VMPS workshops also evaluated nurses' duties and reassigned work, such as room setup, to other staff, thereby increasing the nurse-patient time from 35 percent to more than 90 percent.
This, of course, leads to better patient care.
Kaplan concludes his piece by emphasizing that their improvements are repeatable at any healthcare organization. Waste certainly abounds.. and it's fixable… having a CEO leading the charge certainly increases your chances for success…