1st Edition

A Leadership Journey in Health Care Virginia Mason's Story

By Charles Kenney Copyright 2015
    186 Pages 4 B/W Illustrations
    by Productivity Press

    186 Pages 4 B/W Illustrations
    by Productivity Press

    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
    Retention: Orientation and Onboarding
    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
    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
    Learning Organization



    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