1st Edition
A Leadership Journey in Health Care Virginia Mason's Story
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Since adapting the principles of the Toyota Production System to health care in 2002, Virginia Mason Health System has made enormous leaps forward in quality, safety, patient experience of care, and affordability. It has achieved world-class levels of patient satisfaction and has been honored as one of the safest hospitals in the country.
A Leadership Journey in Health Care: Virginia Mason's Story supplies an inside look at process improvement from the world leader in applying Lean methods to health care. It presents key lessons learned as well as the best practices developed at Virginia Mason during its 12-year process improvement journey.
Just as important, Virginia Mason’s culture of leadership at all levels sets it apart from others in the health care universe. Describing why it’s critical for leadership to be actively involved in any process improvement initiative, the book illustrates exactly what leadership looks like at all levels within Virginia Mason.
In the book, bestselling author Charles Kenney introduces breakthrough new work at Virginia Mason that most health care audiences have yet to read about. He details the reasons why governance has played such a big role in Virginia Mason’s success and discusses a game-changing initiative concerning respect for people.
After reading this book, you will better understand the active leadership style that has propelled Virginia Mason’s success. By following the best practices and lessons learned, you will be prepared to teach, coach, and encourage your team to achieve streamlined and standardized work, sustained improvements, and increased patient satisfaction.
Foreword by Carolyn Corvi, Virginia Mason Health System/Virginia Mason Medical Center Boards of Directors; Retired Vice President and General Manager, Boeing Commercial Airplanes
A Leadership Story
To Be the Quality Leader and Transform Health Care
Virginia Mason Is Different
The Characteristics that Differentiate Virginia Mason
What Does Leadership Look Like?
Strategic Plan: The Power of Alignment
It Is Crystal Clear; There Is No Ambiguity. The Patient Is at the Top… Everything We Do Is Focused on the Patient
You’ve Got to Live This Every Day and If You Think … We Don’t Need to Do It You’re Wrong
To Be the Quality Leader and Transform Health Care
Alignment: Here Is My True North… This Guide, This Roadmap that Tells Me What I Should Be Doing
Alignment Essential to Setting Organizational Goals
Sourcing and Diversity
Selection
Retention: Orientation and Onboarding
Marketing/Branding
Natural Synergy: Strategic Plan and Physician Compact
New Management Method, New Ways to Lead
Ice in His Veins
It’s Been Successful, but Back Then We Didn’t Know
Bet the Farm Strategy
There Is Hope and Optimism and a Sense that, Yes, We Can Do This
We Are All Held Accountable
World-Class Management
Sarah Patterson: A Leader’s Voice
The Variation Itself Kills the Product
You’re Still Doing These Workshops?
If We Didn’t Have VMPS Now I Would Be Terrified
Respect for People: Essential to the Virginia Mason Production System
Wow, How Shallow Are We?
Invisible Workers
There Is Bullying in Health Care and You Have to Commit to Respectful Behavior
Our Goal Is to Have a Team that Feels Respected and Valued and Heard
Respect for People Has to Do with Treating People Well but, More Importantly, with Maximizing Human Potential
Respect for People Makes Lean Management Work
A Substantial Barrier to Progress in Patient Safety Is a Dysfunctional Culture Rooted in Widespread Disrespect
Foundational Behaviors of Respect for People
Theater as Training
I Have a Concern
We Are All in the Same Value Stream
What Does Leadership Look Like?
We Are a Leadership Team, not a Compilation of Leaders
A Team Journey
The Gold Is in the Work of the Team, not Superstars
The Essential Nature of Trust
Most of the Leaders Here Are Intrinsically Motivated
It Is the Egalitarian Sense that Every Team Member Has Something Valuable to Add
Identifying Talent, Developing Leaders
Ready-Now
Leaders
Dr. Joyce Lammert, Hospital Medical Director
Leanne Lewis, Administrative Director, Anatomic Pathology and Clinical Laboratories
Katerie Chapman, Vice President of Perioperative and Support Services
Dr. Donna Smith, Medical Director of Clinic
Shelly Fagerlund, Vice President, Clinic Operations
A Very Different Kind of Board
Case 1: Optical Implant Error
Case 2: Billing Chaos
Case 3: Failure to Recognize Emergent Symptoms
A Very Different Kind of Board
Jamie Brings a Unique Level of Health-Care Expertise
Rigorous Evaluations of Board Members
Board Compact: Foundation for a Robust Governance Evaluation System
The Virginia Mason Institute: Leading the Vision to Transform Health Care
Dr. Craig Grimes: Frazzled, Overwhelmed, Skeptical
When You Look at Your Practice from a Population Standpoint You See It Differently
Everything Gary Said Resonated with Me
It Was a Life-Changing Experience
The Lean Tools and Virginia Mason Principles Resonate Extremely Well Here
Can We Really Do What Virginia Mason Has Done?
Doctors Were Unhappy and Revenues Were Down
We Learned an Important Lesson, and There Were a Lot of Hurt Feelings
With VMPS We Can Do So Much More for Patients
Virginia Mason’s Essential Elements
Optimism
Humility
Teamwork
Courage
Transparency
Alignment
Learning Organization
Accountability
Urgency
Index
Biography
Charles Kenney
When I’m asked to name the best health care delivery system in the country, I answer without hesitation: Virginia Mason. No other organization has developed so many innovations—a unique approach to process improvement modeled on Toyota's, a world-class governance structure, the Physician Compact, and more—and woven them together in the service of a singular goal: putting patients first. In this well-written and engaging book, Kenney pulls back the curtain to describe how Virginia Mason makes all of this work. No surprise: the secret sauce is leadership. Read the book and you’ll become a better leader. Better yet, have everybody at your organization read the book and it will become a better health system.
—Robert Wachter, MD, Professor of Medicine, University of California, San Francisco, and author of The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age
In a series of riveting, rich, and highly informative stories, Charles Kenney provides details and insights into the magic behind the method that can transform health care: a totally new style of collaborative leadership based on trust, alignment, patient focus, respect, and responsibility. Must reading for every health care CEO and Board member.
—Lucian Leape, MD, Harvard School of Public Health
Kenney’s account of the Virginia Mason leadership journey offers a roadmap for young potential leaders on how to pursue a high performance health system.
—David Blumenthal, MD, President, The Commonwealth Fund
To successfully achieve a turnaround you must see Lean as the strategy, understand that the transition has to be led from the top and that the thing you are trying to transform is your people [your most valuable asset]. Virginia Mason touches all the bases here with particular emphasis in this book on the need for strong, aligned leadership throughout the organization. Every company can learn from VM’s leadership examples. A must-read if you are interested in unlocking the hidden value within your company.
—Art Byrne, former CEO of The Wiremold Company and author of The Lean Turnaround
This practical leadership guide shares the strategy, the management tools and systems, and a vision of the culture needed to thrive in today’s challenging health care world. Readers will get a detailed view of the Virginia Mason Production System and the methods that Virginia Mason leaders use to achieve world-class results for their patients.
—Maureen Bisognano, President and CEO, Institute for Healthcare Improvement
Talented people leading and working together on a comprehensive continuous improvement strategy and relentless implementation plan to deliver a compelling vision! Virginia Mason’s Story has important lessons for all of us!
—Alan Mulally, retired CEO of Ford and Boeing Commercial Airplanes
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