Every healthcare organization can learn from Seattle Children’s continuous improvement process, but this book is not an operator’s manual. Instead, it is a challenge to everyone concerned with healthcare to reexamine deeply held assumptions. While it is commonly believed that improved quality, access, and safety, and an improved bottom line are mutually exclusive, Seattle Children’s demonstrates that it quite possible to realize all these improvements concurrently. Written by remarkable change agents from the front lines at Seattle Children’s and other forward-thinking organizations, this book discusses ways to transform key personnel into change agents and engage all staff in a patient-focused culture dedicated to eliminating waste and improving all aspects of quality and care.
Change agents from Seattle Children’s Hospital, Jefferson Healthcare, and The Everett Clinic in Washington; Memorial Care in California; and Minnesota Children’s Hospital and Clinics all make contributions to this book. Each one tells of challenges overcome through continuous improvement. Providing both example and inspiration, these organizations stand as proof that effective mindful change is feasible. Their stories of hard-gained progress is for healthcare professionals who have the willingness to look critically at their work and the tenacity to find better, less wasteful ways to deliver safe, high-quality care.
Seattle Children’s Hospital will change your mind about what’s possible.
Joan Wellman and her colleagues provide examples of dramatic performance improvements. Using their practical examples, you can be on your way to becoming a leader who transforms your organization, empowers your team, adds value, and saves lives.—Ken Graham, CEO, El Camino Hospital, Mountain View, California
… Pat Hagan and his colleagues tell a compelling story of change at an enormously prestigious institution …. It is a story of humility and the courage to go outside of healthcare to learn. … while 10 years ago, lean in healthcare was interesting, today it is essential.—J. Michael Rona, Rona Consulting Group
Joan Wellman and co-authors Pat Hagan and Howard Jeffries are true pioneers in the lean healthcare world. Their book… puts lean into the right context for healthcare leaders and change agents. …Engaging and well-written, I recommend it highly.
—Mark Graban, author of Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction
Table of Contents
The Continuous Performance Improvement (CPI) Journey: A Long and Winding Road; Patrick Hagan
Creating High-Powered Healthcare Improvement Engines; Joan Wellman
What We Need Most We Can’t Buy: Leadership and Culture Change Engaging Everyone in a Patient-Focused Culture; Patrick Hagan and Cara Bailey
Transforming Doctors into Change Agents; Jeffrey Avansino, Ken Gow, and Darren Migita
Clinician Engagement: CPI Applied in a Not-So-Touchy-Feely Environment; Bryan King, Ruth Benfield, and Debra Gumbardo
Ending the Paper Chase in the Operating Room; Sally E. Rampersad and Lynn D. Martin
5S and Demand Flow: Making Room for Continuous Improvement; Charles Hodge and Devin Prenevost
Developing and Implementing Pull Systems in the Intensive Care Unit; Kristina H. Deeter and Jerry J. Zimmerman
Delivering Compassionate Care through Clinical Standard Work on Rounds; Glen Tamura and Darren Migita
Developing Standardized Inpatient Care for Patients with Asthma; Edward Carter and John Salyer
Change That Nourishes the Organization: Making the Total Parenteral Nutrition (TPN) Process Safer; Polly Lenssen, Eric Harvey, and David L. Suskind
Eliminating Mistakes—and Central Line–Associated Bloodstream Infections; Debra Ridling, Howard E. Jeffries, and Danielle Zerr
Balancing the Line in Outpatient Pharmacy; Steven D. Wanaka and Barb Marquardt
Making the Right Call: The Everett Clinic Registration to Cash Value Stream; Janeen Lambert and Iwalani Paquette
Working Hard to Improve Work Flow in the Lab; Bobbi J. Kochevar and Mark D. Schumann
Rapid Changeover in the Operating Room; Sean H. Flack and Lynn D. Martin
CPI in Basic and Clinical Research; Stephanie S. Axelrod, F. Bruder Stapleton, and James Hendricks
Integrated Facility Design at Seattle Children’s Hospital; Michael Boyer , Lisa Brandenburg, and Joan Wellman
Leading Cost Reductions in Healthcare; Tamra Kaplan and Michael Boyer
Back from the Brink: The Jefferson Healthcare Turnaround; John Nowak and Teresa Deason
"… a compelling story of change at an enormously prestigious institution … The story is really about the evolution of thinking by the leadership about the management system necessary to truly create a world class healthcare system. … a story about leadership deciding that a true commitment to customers (patients) meant going and seeing what was really happening to them at the front line. … It is a story about leadership taking the long view and systematically improving. It is a story of humility and the courage to go outside of healthcare to learn. … The reader gets to enjoy the 10 year story of transformation from the perspective of the staff and clinician leaders."
—J. Michael Rona, Principal, Rona Consulting Group, Former president of Virginia Mason Medical Center, Seattle, Washington, where he introduced the Toyota Management System in 2000
"Joan Wellman and her colleagues provide examples of dramatic performance improvements. Using their practical examples you can be on your way to becoming a leader who transforms your organization, empowers your team, adds value, and saves lives."
—Ken Graham, CEO of El Camino Hospital in Mountain View, California
"Joan Wellman and co-authors Pat Hagan and Howard Jeffries are true pioneers in the Lean healthcare world. Their book, Leading the Lean Healthcare Journey, puts Lean into the right context for healthcare leaders and change agents. … presents all of the aspects of a management system that will create alignment and improvement from top-to-bottom, from arrival-to-discharge, each and every day. Engaging and well-written, I recommend it highly."
—Mark Graban, Shingo Prize-Winning Author of Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction