How St. Mary’s Hospital (Ontario) Succeeds Through Staff Kaizen Ideas


Back in 2014, I wrote about a CBC radio piece that featured, among other organizations, St. Mary's General Hospital in Ontario:

You can check out that post with a link to the CBC audio and my summary of it:

Must Listen: CBC Radio Piece on #Lean in Ontario, ThedaCare, and Saskatchewan

Fom that post:

“At St. Mary's, Lean has meant:

  • Less waiting better quality
  • Lower mortality, less cost
  • No patients waiting for bed in ED

[CEO Don] Shilton says they couldn't have done it (gotten improvements on that scale) without Lean.”

Here's a more recent article that I ran across on St. Mary's:

St. Mary's No. 1 after acting on flow of staff ideas


From the article:

“St. Mary's General Hospital ranked first in Canada in a comparison of patient survival rates.”

What more important measure is there other than patient outcomes?

Lean, of course, is not just about cost or efficiencysafety and quality are the top priorities in any Lean organization.

What's one key contributor to the results at St. Mary's? Not just Lean, but more specifically Kaizen – or the embracing of employee-driven ideas and problem solving.

“[CEO Shilton] credits the hospital adopting a quality improvement methodology that encourages staff to propose ideas, then implement them and measure the results. Last year, the goal was one improvement idea for every employee — and they beat it with more than 1,300. This year the number was doubled and they're on track to meeting that target.

“The ideas go from the very simple to the very complex,” Shilton said.”

Kaizen is not a new-fangled suggestion box, where ideas flow upward to some committee or executives to evaluate and implement.

In a Kaizen approach, most ideas stay owned by a local team and the employees (and manager) in that area. Things only get escalated when truly necessary.

The 5-step Kaizen process from our Healthcare Kaizen book is:

  1. Find (opportunities, problems, or ideas)
  2. Discuss
  3. Implement (test)
  4. Document
  5. Share

A goal of one idea per employee is a good start… as is two per employee per year. I haven't found too many organizations in healthcare yet that average more than two ideas per employee per year (even at Franciscan St. Francis, which does a wonderful job at this – see videos about them).

World class manufacturing companies implement 50 ideas per employee per year or more.

It's good to see healthcare keep working and moving in that direction – or at least some organizations. I wish more health systems were using this approach. A “culture of continuous improvement” is still not the norm in healthcare.


“The intensive care team looked for ways to reduce the average time a patient is on a ventilator, getting it down to six days from nine.

“And they're not done yet,” Shilton said.”

Nobody's ever done improving. Keep up the great work, St. Mary's!

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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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