Dr. Gary Kaplan’s Introduction to “The Executive Guide to Healthcare Kaizen”


Executive Guide to Healthcare Kaizen Cover

It's been just over five years since the first edition of my book  Lean Hospitals was released and just over a year since  Healthcare Kaizen was released.

Joe Swartz and I are happy to say that  The Executive Guide to Healthcare Kaizen should be available in the next week or so (via in paperback via  our publisher, CRC Press  or  Amazon, Kindle format, and PDF). Learn more about the book, pre-order, or learn more about the differences between this edition and the original book (which will still be available).  Update: the book is out of “pre-order” status at CRCpress.com and Amazon.

We were thrilled that Gary Kaplan, CEO of Virginia Mason Medical Center, would write a new introduction for this edition, printed below.

By Gary S. Kaplan, MD, Chairman and CEO, Virginia Mason Medical Center, Seattle

GaryKaplanThe value of using Kaizen to improve health care systems is indisputable. At Virginia Mason, we have been using Kaizen, based on the Toyota Production System, for more than a decade. The Virginia Mason Production System, as we call it, has allowed us to deliver safer, better and more affordable care to our patients.

One of the keys to successful implementation of Kaizen is the serious commitment of leaders – including the CEO, senior executives, physician leaders, and Boards of Directors. In our organization, all leaders attend mandatory Kaizen training, are required to lead formal improvement events each year, and are expected to routinely coach and train employees about how to improve their work using Kaizen tools and methods. Kaizen is not a program or an activity that is the sole responsibility of one department; it is the management method used by all leaders at Virginia Mason to guide and operate every aspect of the organization.

Physician leadership is an important part of leadership commitment. An organization that reforms around physicians but doesn't involve them in the process will have difficulty succeeding in the long run. In my experience, the organizations with strong physician leadership and active physician involvement at all levels are best prepared to deliver change through Kaizen.

Kaizen tools encourage and guide change in day-to-day work by all employees. As employees gain better understanding of Kaizen, they use its methods to improve how they do their work. At Virginia Mason, we encourage employees to record their improvement ideas as “Everyday Lean Ideas” and share them with the organization so they can be replicated across the medical center.

As it relates to employee engagement, Kaizen can't be imposed from above. Leaders should introduce, teach and encourage the adoption of Kaizen methodologies, but it is only sustained when employees are engaged – because they have found that it makes their work easier and more satisfying. Employees become champions of Kaizen when they see it reduces the burden of work and the waste of rework and waste of time that come with inefficiency.   It frees them to do the important things that add value for our patients and helps them recapture the passion that drove their original career decisions to work in health care.

Learning to use Kaizen consistently and effectively requires serious culture change and takes many years. This is really not unexpected, as using Kaizen requires deep organizational changes — changes that challenge long-held beliefs and many accepted practices. Our results have been gratifying and propel us to work even harder to deploy these methods and tools deeply within our organization. I believe this book will help any willing health care leader who sets out on the Kaizen journey to achieve similar success.

Learn more about the books Healthcare Kaizen and The Executive Guide to Healthcare Kaizen via our recently re-designed website.  

Amazon has recently offered some really good discounts on my books – 35% off Lean Hospitals  and 35% off  Healthcare Kaizen  (and 21% off The Executive Guide).

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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. Mark –

    Congrats on the new edition and the new book! It is awesome to see the progression of lean in the hospitals. I hope the effort continues to grow!

    Great work.


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