1st Edition

Accelerating Health Care Transformation with Lean and Innovation The Virginia Mason Experience

By Paul E. Plsek Copyright 2014
    216 Pages 15 B/W Illustrations
    by Productivity Press

    Virginia Mason Medical Center (VMMC) was one of the first health care organizations to implement Lean and its methodologies. Other organizations have followed VMMC’s lead, but this world class organization still leads in the utilization of innovative Lean tools.

    Accelerating Health Care Transformation with Lean and Innovation: The Virginia Mason Experience describes how VMMC has systematically integrated innovative structures, methods, and cultural practices into its implementation of Lean. Describing how your organization can create a strategy and build a culture of innovation and learning, it supplies concrete examples that show—not just conceptually, but through VMMC's actual experiences—how Lean and innovation can work hand-in-hand to incrementally improve and radically transform your value streams.

    Explaining how to use the voices and experiences of patients and their families to drive improvement and innovation in new directions, the book supplies a clear understanding of how Lean can help you achieve your goals in today’s increasingly demanding marketplace.

    Virginia Mason, Lean, and Innovation
    A Leader in Lean Thinking in Healthcare
    Lean Thinking Basics
    Creativity and Innovation Basics
    Virginia Mason’s Chair of Innovation
    The Marriage of Lean and Innovation at Virginia Mason Medical Center

    Strategy as Innovation, Strategy for Innovation
    The Challenge of Innovation in Healthcare
    Seat-of-the-Pants versus Deliberately Planned Innovation
    Are You Guys Kidding Me? The Patient at the Top of a Pyramid!
    Four Strategic Pillars Support Pursuit of the Perfect Patient Experience
    Looking Outside for Insight: The Birth of the Virginia Mason Production System
    Gaining outside Insight on Innovation
    Evolution of the Strategic Innovation Plan
    Listening to the Voice of the Future
    Stimulating Breakthrough Innovation
    The Board’s Role in Strategy and Innovation: You Have to Be on the Team
    Transforming Healthcare: What Others Can Learn from Virginia Mason’s Innovation Strategy
    Leaders in Other Healthcare Organizations Should

    Integrating Innovation and Lean in Practice
    Debunking the Myth
    Integrating Lean and Innovation: Natural Overlaps in Tools and Methods
    The Marriage of Lean and Innovation: A Careful Courtship
    Innovation and Lean in Hospital Design
    Innovating in Primary Care
    Busting Assumptions about the Management of Medically Complex Surgical Patients
    Redesigning Surveillance of Healthcare-Acquired Infections
    Embedding Innovation Tools into the Structure of Lean Workshops
    Transforming Healthcare: What Others Can Learn from Virginia Mason’s Integration of Lean and Innovation Tools
    Leaders in Other Healthcare Organizations Should

    Learning to Be Innovative
    Learning and Unlearning
    Key Concepts: Pedagogy, Andragogy, and Reflective Practice
    Creating a Learning Organization: There Are No Shortcuts
    A Quick Word about Leaders and Leadership
    Virginia Mason’s Systematic Approach to Skills Development for Leaders
    Structural Practices that Support Innovative Thinking in Leaders
    Evolution of Training and Development for Innovation
    Virginia Mason’s Innovation Competencies
    Transforming Healthcare: What Others Can Learn from Virginia Mason’s Innovation Leadership Knowledge and Capability Efforts
    Leaders in Other Healthcare Organizations Should

    Supportive Culture for Innovation
    Dimensions of Culture that Support Innovation
    Innovation Culture Does Not Exist in a Vacuum
    Examples of the Seven Dimensions of Culture at Virginia Mason
    Describing Organizational Culture for Innovation: Portal Charts
    Assessing Organizational Culture for Innovation
    Virginia Mason’s Assessment of the Dimensions of Culture that Support Innovation
    Innovation Culture Kaizen
    Transforming Healthcare: What Others Can Learn from Virginia Mason’s Innovation Culture Efforts
    Leaders in Other Healthcare Organizations Should

    Supportive Infrastructure for Innovation
    Examples of Innovation Infrastructures in Leading Healthcare Institutions
    Infrastructure Evolves in Context
    The Kaizen Promotion Office (KPO): Supporting the Implementation of the Virginia Mason Production System
    Innovation Leadership Team (ILT): Providing Board and Executive Level Guidance for Innovation
    Center for Innovation: The Small Team behind the Scenes
    Information Technology Supports for Innovation: Browsing for Knowledge and Ideas
    Emerging Infrastructures: Innovation Grants and Moonshine
    Communications Infrastructure: Getting the Word Out about Innovation
    Center for Health Care Solutions: Catalyzing Breakthrough Innovations in Care by Supporting Uncommon Conversations
    Transforming Healthcare: What Others Can Learn from Virginia Mason’s Innovation Infrastructure Efforts
    Leaders in Other Healthcare Organizations Should

    Bringing Innovation to Daily Work
    "I Swore I Was Going to Find a Way to Make That Never Happen Again"
    "We’re Throwing Everything, Including the Kitchen Sink, at You"
    Bringing Fresh Ideas to the Daily Practice of Surgery
    KVM Radio
    "I’m Doing It Today, and Never Again"
    The Everyday Lean Idea System
    Making Things Better While the Moon Is Shining
    Informatics Practitioners: Making Better Use of Information in Daily Clinical Work
    Innovation Grants Process: Supporting Those with Potential Breakthrough Ideas
    Transforming Healthcare: What Others Can Learn from Virginia Mason’s Innovation in Daily Work Efforts
    Leaders in Other Healthcare Organizations Should

    Using Patient Experience to Drive Innovation
    The Customers’ Role in Innovation
    Evolution of the Strategic Focus on Service
    Imported from the UK: Experience-Based Design
    Experience-Based Design Meets Standard Work in a Clinic
    Understanding the Emotional Experience of Surgical Patients and Families
    You Can See a Lot by Looking
    I Am Sure That This Is What They Will Want
    The Roller Coaster of Emotion
    The Case of the Critical Care Unit
    Building the Infrastructure to Support Experience-Based Design
    Team Members Have Emotional Experiences Too!
    Transforming Healthcare: What Others Can Learn from Virginia Mason’s Focus on Patients and Families
    Leaders in Other Healthcare Organizations Should

    Looking Ahead: The Future of Innovation and Lean at the Virginia Mason Medical Center
    A Strategic Plan that Stands the Test of Time
    Further Embedding Innovation Methods in VMPS
    Creating More Capability through Culture Development, Education, and Infrastructure
    Enhancing the Implementation of Experience-Based Design Methodology
    Looking Outward to Innovate
    Creating Breakthrough Innovation to Transform the Healthcare Marketplace
    Hearing the Voice of the Future while Avoiding the Siren Call of Technology Alone
    Spreading the Word to Transform Healthcare
    Moon Shots for Management

    Source Notes


    Paul E. Plsek

    "Lean sounds mean; innovation sounds risky. But both are at the heart of what people do every day at VMMC. With lucid descriptions and riveting examples, Paul Plsek tells us how this top-rated health care organization created the culture and provided the tools so that everyone can innovate and learn. A treasure trove of insights for all who, like VMMC, strive to provide a ‘perfect patient experience’."
    —Lucian L. Leape, MD, Harvard School of Public Health

    "Health care organizations are being asked to do the seemingly impossible: become defect-free by standardizing core processes and reducing waste, while nurturing a culture of innovation. In this superb and highly readable book, management guru Paul Plsek describes how one US medical center – Seattle’s Virginia Mason – managed to achieve these twin goals. He argues convincingly that the goals of "Lean thinking" and innovation are not in tension; rather, when approached the right way, they are highly synergistic. Plsek writes with insight, experience, and clarity, and the book is chock-full of inspiring examples and practical tools. If I were leading an effort to improve the care delivered by my organization, this would be the first book I would distribute to all of my clinicians, staff, administrators, and board members."
    —Robert M. Wachter, MD, Associate Chair, Department of Medicine, University of California San Francisco

    "The practical tools and approaches Plsek offers are helpful for health care providers at all levels. This book demonstrates, through the remarkable journey of Virginia Mason Medical Center, what can be accomplished when leadership, Lean thinking, and creative innovation all align."
    —Maureen Bisognano, President and CEO, Institute for Healthcare Improvement

    "Few organizations in health and medical care have created a learning system aimed at achieving performance that is better everyday than it was the day before. The system involves every employee, every board member, every patient, and ideas and practices from every industry and geography. Virginia Mason is not a finished product, but if you are interested in learning how to pursue excellence in a non-random way.....you should read this book."
    —Paul O'Neill, Former Chairman and Chief Executive Officer Alcoa and the 72nd Secretary of the US Treasury

    "Health care is in the midst of a massive transformation – a true ‘100 year storm’ that will thin the weak but leave the strong standing even taller. This volume outlines the deep roots, based in Lean quality theory, that can anchor a care delivery group to withstand the blasts and thrive in the gale. It comes from one of the few whole truly know – a rare organization that models the principles, and harvests the results, that will form the next generation of health care delivery. Most important, it addresses fundamentals – the core infrastructure from which any world-class organization grows – at a level of sufficient practical detail to actually be useful to others striving for excellence in the field."
    —Brent C. James, MD, M.Stat, Chief Quality Officer and Executive Director, Institute for Health Care Delivery Research, Intermountain Healthcare

    "This is the ‘must-read’ text for anyone in healthcare who is interested in improvement and innovation. It is easy to read, provides lots of stories, and describes how evidence can, and has been put into action through real world examples. Many people will recognise that Virginia Mason has been successfully using Lean methods but most will be surprised by their clever use of both innovation and Lean methods together thus creating significantly more value than using either alone and dispelling the myth that Lean and innovation methods cannot work in harmony. There is a clear message that patients are the number one priority. We see how they actively seek to deeply understand patient’s experiences and how they engage both patients and staff to create innovations that make the biggest difference. To achieve innovation leaders cannot rely on tools and techniques alone, they have to create the conditions that support staff to excel. Rather than putting this into the ‘too difficult’ list we see how Virginia Mason leadership teams have committed to achieving conditions within which innovation can flourish.

    As you travel through this book you will recognise some of the struggles that healthcare teams from around the world face, read on and you will learn valuable lessons about how you too can overcome these to create a thriving organisation that provides an excellent service for patients and an excellent workplace for staff."
    —Dr. Lynne Maher, Director for Innovation, Ko Awatea, Middlemore Hospital, Auckland, New Zealand