Healthcare Kaizen focuses on the principles and methods of daily continuous improvement, or Kaizen, for healthcare professionals and organizations. Kaizen is a Japanese word that means "change for the better," as popularized by Masaaki Imai in his 1986 book Kaizen: The Key to Japan's Competitive Success and through the books of Norman Bodek, both of whom contributed introductory material for this book. Winner of a 2013 Shingo Research and Professional Publication Award! In 1989, Dr. Donald M. Berwick, founder of the Institute for Healthcare Improvement and former administrator of the Centers for Medicare and Medicaid Services, endorsed the principles of Kaizen in the New England Journal of Medicine, describing it as "the continuous search for opportunities for all processes to get better." This book shows how to make this goal a reality. Healthcare Kaizen shares some of the methods used by numerous hospitals around the world, including Franciscan St. Francis Health, where co-author Joe Swartz has led these efforts. Most importantly, the book covers the management mindsets and philosophies required to make Kaizen work effectively in a hospital department or as an organization-wide program. All of the examples in the book were shared by leading healthcare organizations, with over 200 full-color pictures and visual illustrations of Kaizen-based improvements that were initiated by nurses, physicians, housekeepers, senior executives and other staff members at all levels. Healthcare Kaizen will be helpful for organizations that have embraced weeklong improvement events, but now want to follow the lead of ThedaCare, Virginia Mason Medical Center, and others who have moved beyond just doing events into a more complete management system based on Lean or the Toyota Production System. It's often said, without much reflection, that people hate change. The experiences shared

Organizations around the world are using Lean to redesign care and improve processes in a way that achieves and sustains meaningful results for patients, staff, physicians, and health systems. Lean Hospitals, Third Edition explains how to use the Lean methodology and mindsets to improve safety, quality, access, and morale while reducing costs, increasing capacity, and strengthening the long-term bottom line.This updated edition of a Shingo Research Award recipient begins with an overview of Lean methods. It explains how Lean practices can help reduce various frustrations for caregivers, prevent delays and harm for patients, and improve the long-term health of your organization.The second edition of this book presented new material on identifying waste, A3 problem solving, engaging employees in continuous improvement, and strategy deployment. This third edition adds new sections on structured Lean problem solving methods (including Toyota Kata), Lean Design, and other topics. Additional examples, case studies, and explanations are also included throughout the book.Mark Graban is also the co-author, with Joe Swartz, of the book Healthcare Kaizen: Engaging Frontline Staff in Sustainable Continuous Improvements, which is also a Shingo Research Award recipient. Mark and Joe also wrote The Executive's Guide to Healthcare Kaizen.

Hospitals and health systems are facing many challenges, including shrinking reimbursements and the need to improve patient safety and quality. A growing number of healthcare organizations are turning to the Lean management system as an alternative to traditional cost cutting and layoffs. "Kaizen," which is translated from Japanese as "good change" or "change for the better," is a core pillar of the Lean strategy for today's best healthcare organizations. Kaizen is a powerful approach for creating a continuously learning and continuously improving organizations. A Kaizen culture leads to everyday actions that improve patient care and create better workplaces, while improving the organization's long-term bottom line. The Executive Guide to Healthcare Kaizen is the perfect introduction to executives and leaders who want to create and support this culture of continuous improvement. The Executive Guide to Healthcare Kaizen is an introduction to kaizen principles and an overview of the leadership behaviors and mindsets required to create a kaizen culture or a culture of continuous improvement. The book is specifically written for busy C-level executives, vice presidents, directors, and managers who need to understand the power of this methodology. The Executive Guide to Healthcare Kaizen shares real and practical examples and stories from leading healthcare organizations, including Franciscan St. Francis Health System, located in Indiana. Franciscan St. Francis' employees and physicians have implemented and documented 4,000 Kaizen improvements each of the last three years, resulting in millions of dollars in hard savings and softer benefits for patients and staff. Chapters cover topics such as the need for Kaizen, different types of Kaizen (including Rapid Improvement Events and daily Kaizen), creating a Kaizen culture, practical methods for facilitating Kaizen improvements, the role of senior leaders and other leaders in Kaizen, and creating an organization-wide Kaizen program. The book contains a new introduction by Gary Kaplan, MD, CEO of Virginia Mason Medical Center in Seattle, Washington, which was named "Hospital of the Decade" in 2012. The Executive Guide to Healthcare Kaizen is a companion book to the larger book Healthcare Kaizen: Engaging Front-Line Staff in Sustainable Continuous Improvements (2012). Healthcare Kaizen is a longer, more complete "how to" guide that includes over 200 full color images, including over 100 real kaizen examples from various health systems around the world. Healthcare Kaizen was named a recipient of the prestigious Shingo Professional Publication and Research Award. Check out what the experts at the Franciscan St. Francis Health System have to say about Healthcare Kaizen. http://www.youtube.com/watch?v=XcGmP5gLEPo&feature=c4-overview&list=UU7jiTxn4nkMzOE5eTbf0Upw

Hospitals and health systems are facing many challenges, including shrinking reimbursements and the need to improve patient safety and quality. A growing number of healthcare organizations are turning to the Lean management system as an alternative to traditional cost cutting and layoffs. "Kaizen," which is translated from Japanese as "good change" or "change for the better," is a core pillar of the Lean strategy for today's best healthcare organizations.Kaizen is a powerful approach for creating a continuously learning and continuously improving organizations. A Kaizen culture leads to everyday actions that improve patient care and create better workplaces, while improving the organization's long-term bottom line. The Executive Guide to Healthcare Kaizen is the perfect introduction to executives and leaders who want to create and support this culture of continuous improvement.The Executive Guide to Healthcare Kaizen is an introduction to kaizen principles and an overview of the leadership behaviors and mindsets required to create a kaizen culture or a culture of continuous improvement. The book is specifically written for busy C-level executives, vice presidents, directors, and managers who need to understand the power of this methodology. The Executive Guide to Healthcare Kaizen shares real and practical examples and stories from leading healthcare organizations, including Franciscan St. Francis Health System, located in Indiana. Franciscan St. Francis employees and physicians have implemented and documented 4,000 Kaizen improvements each of the last three years, resulting in millions of dollars in hard savings and softer benefits for patients and staff. Chapters cover topics such as the need for Kaizen, different types of Kaizen (including Rapid Improvement Events and daily Kaizen), creating a Kaizen culture, practical methods for facilitating Kaiz

Organizations around the world are using Lean to redesign care and improve processes in a way that achieves and sustains meaningful results for patients, staff, physicians, and health systems. Lean Hospitals, Third Edition explains how to use the Lean methodology and mindsets to improve safety, quality, access, and morale while reducing costs, increasing capacity, and strengthening the long-term bottom line.

This updated edition of a Shingo Research Award recipient begins with an overview of Lean methods. It explains how Lean practices can help reduce various frustrations for caregivers, prevent delays and harm for patients, and improve the long-term health of your organization.

The second edition of this book presented new material on identifying waste, A3 problem solving, engaging employees in continuous improvement, and strategy deployment. This third edition adds new sections on structured Lean problem solving methods (including Toyota Kata), Lean Design, and other topics. Additional examples, case studies, and explanations are also included throughout the book.

Mark Graban is also the co-author, with Joe Swartz, of the book Healthcare Kaizen: Engaging Frontline Staff in Sustainable Continuous Improvements, which is also a Shingo Research Award recipient. Mark and Joe also wrote The Executive’s Guide to Healthcare Kaizen.

Table of Contents

The Need for Lean Hospitals

Better Results with Lean

Why Do Hospitals Need Lean?

A Renewed Sense of Purpose

Lean Methods Are Not New to Healthcare

Toyota’s Role in Popularizing Lean

Origins of the Term Lean

Lean Is Proven to Work outside Automotive Factories

Lean Is Helping Hospitals Improve

Problems in Healthcare

Good Quality Costs Less

Interconnected Benefits

A Snapshot of Department Success: Laboratory, Children’s Health Dallas

From Departmental to Hospital- and System-Wide Success

Conclusion

Lean Lessons

Points for Group Discussion

Notes

Overview of Lean for Hospitals and Health Systems

What Is Lean?

Ohno’s Definition of Lean

Lean Thinking

The Toyota Triangle: Tools, Culture, and Management System

The "Toyota Way" Philosophy

Four Organizational Capabilities for Lean

Lean and Other Methodologies

What Lean Is Not

Conclusion

Lean Lessons

Points for Group Discussion

Notes

Value and Waste

Waste: A Global Problem with Local Solutions

Reducing Waste Is a Better Goal Than Reducing Cost

What Is Waste?

What Is Value? Start with the Customer

How Do We Define Value in a Broad Sense?

How Does Lean Define "Value?"

Examples of Value-Added and Non-Value-Added Activities

Learning to Identify and Describe Waste

There’s Not Always an Easy Answer

What Non-Value-Added Activities Are Required?

Non-Value-Added, Pure Waste

Conclusion

Lean Lessons

Points for Group Discussion

Notes

Observing the Process and Value Streams

Learning to See

How Do We Find Waste? Go and See

What Is a Value Stream?

Value Stream Mapping

Creating a Current-State Value Stream Map

The Future-State Maps

Breaking Down Silos and Reducing Suboptimization

Observing the Process

Activity of the Product

Activity of the Employee

Conclusion

Lean Lessons

Points for Group Discussion

Notes

Standardized Work as a Foundation of Lean

Helpful Standardization: From 171 Forms to Just Six

The Need for Standardized Work

The Toyota House Metaphor

Overview of the Lean Foundations

Lean Foundations: Standardized Work

Definition of Standardized Work

Standardized, Not Identical

Written by Those Who Do the Work

Considering How Long Tasks Take

Staffing Based on Data

Types of Standardized Work Documents

Standardizing Daily Routines

Defining Roles and Responsibilities

Quick Changeover as Standardized Work

Explaining Why through Standardized Work

Standardized Work Documents and the Standardized Work System

Measuring and Observing for Standardized Work Adherence

"Resistance" to Standardized Work?

Asking Why When Standardized Work Is Not Followed

Standardized Work Can Apply to Physicians

Lean and Checklists

Standardized Work for Raising Concerns

Standardized Work Can Apply to Leaders

Training through Standardized Work

Conclusion

Lean Lessons

Points for Group Discussion

Notes

Lean Methods: Visual Management, 5S, and Kanban

Lean Is More Than Tools, but Tools Can Help

Reducing Waste through Visual Management

Examples of Visual Management for Patient Flow

Examples of Visual Management to Prevent Process Problems

5S: Sort, Store, Shine, Standardize, and Sustain

Safety as a Sixth S?

Kanban: A Lean Approach to Managing Materials

Problems with Traditional Materials Systems

Trade-Offs with Inventory

Using Kanban to Replenish Supplies

Conclusion

Lean Lessons

Points for Group Discussion

Notes

Proactive Root Cause Problem Solving

The Tragic and Preventable Mary McClinton Story

Improving Quality and Patient Safety

Cultural Obstacles to Quality Improvement

Why Do Errors Occur?

Examples of Quality Improvement

Finding Root Causes and Preventing Errors

Workarounds and the Need for Fixing Root Causes

Asking Why Instead of Who

Start at the Gemba

Find Root Causes Using Simple Methods

A3 Problem Solving

Toyota’s Practical Problem Solving

Be Proactive and Use Failure Modes and Effects Analysis

Proactive Resolution of Near-Miss Problems

The Heinrich Safety Pyramid

Conclusion

Lean Lessons

Points for Group Discussion

Notes

Preventing Errors and Harm

A Serious Problem with Large, Unknowable Numbers

Moving beyond Blaming Individuals

The Darrie Eason Case

Creating Quality at the Source through Error Proofing

Being Careful Is Not Enough

Why 100% Inspection Is Not 100% Effective

Types of Error Proofing

Error Proofing, Not Dummy Proofing

Examples of Error Proofing in Hospitals

Stopping the Line (Andon)

Error Proofing the Error Proofing

Conclusion

Lean Lessons

Points for Group Discussion

Notes

Improving Flow

Lean Is Both Quality and Flow

Waiting: A Worldwide Problem

Targets without a Means for Improvement Might Lead to Improvement or Dysfunction

Focusing on Flow

Value Streams Should Flow Like a River

Uneven Workloads as a Barrier to Flow

Addressing Mura by Matching Staffing to Workloads

Improving Patient Flow

Improving Flow for Ancillary Support Departments

Conclusion

Lean Lessons

Points for Group Discussion

Notes

Lean Design

Better, Faster, and Cheaper

Understanding the Current State before Designing the Future

Lean Design at East Tennessee Children’s Hospital

Integrated Lean Project Delivery at Akron Children’s Hospital

Conclusion

Lean Lessons

Points for Group Discussion

Notes

Engaging and Leading Employees

Improving the Way We Manage

What Is a Manager’s Role?

Strategy Deployment

Common Management Problems

Lean as a Management System and Philosophy

A Daily Lean Management System

Performance Measures

Conclusion

Lean Lessons

Points for Group Discussion

Notes

Getting Started with Lean

How Do We Start?

The LEI Lean Transformation Model

Where Do We Start?

What Do We Call It?

Getting Started with Kaizen

Kaizen Events

Lean Transformation Projects

The Lean Project Team

Executive Sponsorship and Leadership

Starting from the Middle

Establishing a Model Line and a Road Map

Dedicating People to Lean Beyond Projects

The Lean Department

The Importance of Change Management

A Snapshot of Hospital Success: Avera McKennan Hospital & University Health Center

Conclusion

Lean Lessons

Points for Group Discussion

Notes

A Vision for a Lean Hospital and Health System

Introduction

When Is a Health System Lean?

What Would a Lean Health System Look Like?

What Would a Patient Experience in a Lean Health System?

What Would It Be Like to Work in a Lean Health System?

How Would We Describe a Lean Health System?

In Conclusion

Points for Group Discussion

Notes

Glossary

Index