In no industry is the concept of quality more essential than it is in healthcare, which is why the lean quality principles learned through the example of the Toyota Production System are so applicable. Two fundamental principles of Toyota’s push for excellence are especially relevant to healthcare: ensuring quality at every step and keeping improvement processes simple enough that they are viable, reproducible, and teachable.
Developed with the input of more than 60 healthcare organizations, Value Stream Mapping for Healthcare Made Easy introduces healthcare managers to the essential method developed by Toyota known as the Value Stream Map (VSM). The first half of the book provides an introduction to VSMs that shows healthcare workers at all levels how to look at any process with eyes that probe all the value-added and non-value-added activities in the delivery of a requested service or product. This will allow all stakeholders the opportunity to evaluate, create, and communicate innovation in their workplace.
The second half reviews real value stream maps at real healthcare facilities created by teams of administrators, managers, physicians, and staff members. Most participants were not experienced with lean thinking and for many this was their first engagement with lean methods. What becomes clear through these examples is the importance of initiating realistic improvements that can quickly demonstrate successful change and encourage even more problem solving.
This ability to be involved with creating a better way to work has been exceptionally well received by workers both at Toyota and now throughout the healthcare industry. Lean thinking involves employees in improving work that is meaningful to them, at a level where they can see and appreciate the changes they have participated in creating. This satisfaction is essential to retaining good workers, as well as to the everyday improvement of safety, patient satisfaction, and affordability.
VSM is a proven high-level view tool that can be used in every aspect of healthcare to identify, understand, and improve processes. Information included illustrates the simplicity and completeness of the tool and describes its applications to staff communication, regulatory documentation, and activities of daily work. The book also highlights simple-to-use data collection and interpretation as part of the VSM process.
Table of Contents
Toyota’s Role in Lean
Advantages of Value Stream Mapping
Part I The Basics of Value Stream Mapping
1 Identifying Waste in Healthcare
2 The Ideal State in Healthcare
3 Adapting the Four Rules in Use to Healthcare Processes
4 Value Stream Mapping the Work of Healthcare
5 Creating and Using Your First Map: The Current-State
6 Building the Vision: The Future State Map
7 Sharing and Archiving VSMs Electronically
8 Beyond the Simple Value Stream Map: Adding More Information
Part II Case Studies
Case Study 1
Scheduling Meeting Rooms
Case Study 2
Employee Continuing Education Tuition Reimbursement
Case Study 3
Routine Medication Ordering (Physician Order
Case Study 4
Assignment of Transporters for Daytime Inpatient Radiology
Case Study 5
Patient Pre-registration for Day Surgery
Case Study 6
Trauma Patient Flow in a Busy Emergency Room
Case Study 7
Total Joint Replacement Scheduling (Operating Room Back-Table Set-up)
Cindy Jimmerson is a pioneer of lean healthcare, having initiated her work with a grant from the National Science Foundation (2001– 2004). She is the founder and president of Lean Healthcare West, an organization of healthcare professionals offering education and implementation of TPS/lean principles in hospital, clinic, and long-term care facilities. She is the author of the reVIEW© Course and Workbook and many journal publications.
The basic work for this book was developed through study and practice by the author, mentoring by manufacturers, healthcare workers, and educators from around the world, and the generous support of the National Science Foundation,. More importantly, it involved the staffs and leaders of more than 60 healthcare organizations who have used this simple but powerful method of looking at work differently as their first step toward improving healthcare delivery. It is their feedback and suggestions that have contributed to the diverse applications of value stream mapping (VSM) for healthcare.
Cindy Jimmerson is a proven and well-known practitioner of Lean methods in healthcare. Her book is full of varied case studies that beautifully illustrate the power of the value stream mapping method and how it fits into a Lean transformation journey.
— Mark Graban, Shingo Prize-Winning Author of Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction
Following her publication A3 Problem Solving for Healthcare, Cindy Jimmerson has produced another excellent book that demonstrates why value stream maps are a fundamental component in applying Lean TPS and how using the A3 and VSM enables you to see the bigger picture and zero in on a specific problem. The selection of case studies reflects the range of common problems across the whole healthcare system. A must read for all.
— Lesley Wright, Director – Diagnostics, NHS Improvement
This book is an invaluable resource for all involved in implementation of Lean in Healthcare. Every reader from novice to veteran practitioner will find what they are looking for here. Cindy Jimmerson has put it all together in a practical guide that covers big concepts, all the technical details, and illustrated case studies that clarify how all of the tools and concepts work together. Jimmerson has demystified the value stream map and made it an actionable tool for all!
—Mimi Falbo, Mimi Falbo LLC
Throughout my nearly 20 year career at Toyota and my consulting work beyond, I have coached many clients on Lean Thinking in a wide range of industries both public and private. Along the way, I have seen many ‘translations’ of Toyota’s approach to other industries and business applications. Sadly, most miss the mark. Some by a lot! I am pleased however that Cindy Jimmerson’s work here is not only true to its Lean roots in Toyota but she has added to the overall body of knowledge in significant ways that make logical extensions and rational adaptations to fit her clients’ unique needs. I would highly recommend this book to anyone desiring to genuinely adopt the Toyota approach to the healthcare industry and to do so with confidence. This is the real deal.
— Ken Pilone, President, Sterling Methods Consulting Group, LLC
This is an outstanding book, the best one available on value stream mapping. Cindy Jimmerson is a remarkable teacher and a pioneer in Lean thinking. Her visual organization in this book (and her book on A3 problem solving) make VSM immediately accessible and useful. The case studies are superb. As a practicing Anesthesiologist, Hospice Physician, and Medical Director, I was fortunate to recently take her course, and I will be applying the information in this book to healthcare for the rest of my career.
— Shaun Sullivan, MD, Partner, Bellingham Anesthesia Associates, Anesthesia Medical Director, Skagit Valley Hospital, Whatcom Hospice Medical Director
Value stream mapping for healthcare is indeed "made easy". Cindy has found the ideal balance of information and application. The examples, step-by-step instructions and "simple, yet elegant" flow of information is ideal for anyone interested in developing their Lean knowledge. Well worth reading and applying.
— Barb Bouche, Director, CPI, Seattle Children’s Hospital
As a former student of Cindy's and owner of many health care processes I can tell you that this book is a remarkable journey from the complex to the simple. By using the tools taught and the elegant examples in this book, one can learn to see apparently complex problems broken down into manageable processes through the use of Cindy's practical application of value stream mapping. When I have used her techniques, once the process was really mapped to reflect the true state of affairs, solutions jump off the page. Unlike other dry management dissertations, this book is rich with real health care examples drawn from the author's own clinical and managerial experience. Cindy is a remarkable teacher and this book captures the essence of her teaching on the effective use of value stream mapping in health care.
— John Salyer RRT-NPS, MBA, FAARC, Author of Managing the Respiratory Care Department, Director Respiratory Therapy Services, Seattle Children's Hospital and Research Institute