Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement, Second Edition

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9781439870433: Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement, Second Edition

Healthcare leaders around the world are facing tough challenges, including the need to deliver better value for patients and payers, which means improving quality while reducing cost. It might seem impossible to do both, but organizations around the world are proving it's possible, through Lean. Health systems are able to enhance all dimensions of patient care, including both safety and service, while creating more engaging and less frustrating workplaces for healthcare professionals and staff... all leading to improved long-term financial performance.

Building on the success of the first two editions of this Shingo Prize-Winning book, Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement, Third Edition explains how to use the Lean philosophy and management system to improve safety, quality, access, and morale while reducing costs. Lean healthcare expert Mark Graban examines the challenges facing today’s health systems, including rising costs, falling reimbursement rates or budget constraints, employee retention, and harm to patients.

The new edition of this international bestseller (translated into eight languages) begins with an overview of Lean methods and mindsets. It explains how engaging staff and leaders in Lean practices such as value stream mapping and process observation can help reduce wasted motion for caregivers, prevent delays for patients, and improve the long-term health of your organization. In addition to a new introduction from John Toussaint, this updated edition includes:

  • New and updated material on identifying waste, A3 problem solving, employee idea management, kanban for materials management, and strategy deployment
  • New case studies and examples―including a new 5S case study (Franciscan St. Francis Health) and other case examples highlighting the challenges and successes of an academic medical center and a small urgent access hospital, featuring quotes and stories from executives
  • New examples and updated data throughout, including revised chapters on patient safety and patient flow challenges and the improvements driven by Lean

Detailing the mindsets and methods needed for a successful transition to a Lean culture, the book provides the understanding of Lean practices―including value stream mapping, standardized work, error proofing, root cause problem solving, and daily improvement processes―needed to reduce common hospital errors and improve performance in other dimensions. The balanced approach outlined in this book will guide you through the process of improving the quality of care and service while reducing costs in your hospital.

*The Lean Certification and Oversight Appeals committee has approved Lean Hospitals as recommended reading for those in pursuit of Lean Bronze Certification from SME, AME, Shingo Prize, and ASQ

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About the Author:

Mark Graban is a consultant, author, keynote speaker, and blogger in the field of Lean healthcare. Mark is an experienced consultant and change agent, with a background in industrial and mechanical engineering and an MBA from the MIT Sloan Leaders for Global Operations Program. Prior to healthcare, Mark worked in multiple industries, including automotive (General Motors), electronics (Dell), and industrial products (Honeywell). At Honeywell, Mark was certified as a Lean Expert (Lean Black Belt).

Since August 2005, Mark has worked exclusively in healthcare, where he has coached Lean teams at client sites in North America and the United Kingdom, including medical laboratories, hospitals, and primary care clinics. Mark's motivation is to apply Lean and Toyota Production System principles to improve quality of care and patient safety, to improve the customer/patient experience, to help the development of medical professionals and employees, and to help build strong organizations for the long term.

From June 2009 to June 2011, Mark was a Senior Fellow with the Lean Enterprise Institute (LEI), a not-for-profit educational organization that is a leading voice in the Lean world. In this role, Mark also served as the Director of Communication & Technology for the Healthcare Value Network, a collaboration of healthcare organizations from across North America, a partnership between LEI and the ThedaCare Center for Healthcare Value. Mark continues as an LEI faculty member.

In June 2011, Mark joined the software company KaiNexus as their Chief Improvement Officer, to help further their mission of "making improvement easier" in healthcare organizations, while continuing his other consulting and speaking activities. Mark was raised in Livonia, Michigan and currently resides in San Antonio, Texas with his wife, Amy. To interact with Mark and the Lean healthcare community, visit LeanHospitalsBook.com.

Review:

Praise for the New Edition of this Shingo Prize Winner:

"Whether it is the ThedaCare story ... Seattle Children’s ... or Virginia Mason, the answer is in: Lean works. The question now for all of you is how are you going to do it? What is the leadership model required? ... There will be many questions, and I believe starting with Mark Graban’s updated book Lean Hospitals is a good first step. ... This book lays out the nuts and bolts of the Lean methodology and describes the more difficult challenges, which have to do with managing change. ... I wish I could have read this in 2004, as it might have prevented some of the mistakes we made in our Lean transformation journey."
John Toussaint, MD, CEO, ThedaCare Center for Healthcare Value

 Praise for the First Edition:

"Leaders of today’s healthcare organizations are on a continuous journey to improve results, requiring a relentless focus on improving the underlying process of care delivery and leadership practices. Mark has written a book that provides compelling ideas to help create better places to work, practice medicine and receive safe, high quality care."
―Quint Studer, Founder and CEO of Studer Group, a 2010 recipient of the Malcolm Baldrige National Quality Award, Author of Hardwiring Excellence: Purpose, Worthwhile Work, Making a Difference and Results That Last: Hardwiring Behaviors That Will Take Your Company to the Top

"Mark Graban is the consummate translator of the vernacular of the Toyota Production System into the everyday parlance of health care. With each concept and its application, the reader is challenged to consider what is truly possible in the delivery of health care if only standardized systems borrowed from reliable industries, were implemented. Graban provides those trade secrets in an understandable and transparent fashion."
―Richard P. Shannon, MD, Frank Wister Thomas Professor of Medicine, Chairman Department of Medicine, University of Pennsylvania School of Medicine

"There is an enormous shortfall between the healthcare we receive and what we actually get. Mark Graban explains how those in the system can make care delivery better for everyone –patients, providers, and payors."
―Steven Spear, Sr. Lecturer at MIT Sloan School of Management and Sr. Fellow at IHI, Author of The High Velocity Edge

"Mark Graban has been tirelessly studying the application of LEAN to health care, with an emphasis on respect for the people served by the system as well as the people who provide excellent care. He has an accurate sense of how things work in health systems, which makes his work more meaningful for people who want to make them better."
―Ted Eytan, MD

"The concepts outlined in this book are the most powerful tools that I have ever encountered to foster innovation, ownership, and accountability at the front line staff level. This is a must-read for any leader in today’s increasingly complex healthcare industry."
―Brett Lee, PhD, FACHE, SVP of Health System Operations at Children's Healthcare of Atlanta

"The Lean approach to healthcare, including a strong emphasis on culture, is the best way to ensure the optimal patient experience. The multiple examples of the application of Lean given in this book provide a wealth of information to draw from for a hospital that is venturing into Lean principles for the first time. In addition, this book emphasizes not only methodology, but also the cultural changes that must occur for sustainability - something often forgotten in change management."
―Beverly B. Rogers, MD, Chief of Pathology, Children’s Healthcare of Atlanta, Clinical Professor of Pathology, Emory University School of Medicine

"Finally! The healthcare industry has needed this book for many years. Informative, understandable, and timely, Mark Graban’s book will leave you with an appreciation for what lean is and what it can do for your hospital. After you read this book, I’ll be surprised if you don’t make implementing lean your highest strategic priority."
―Jim Adams, Senior Director, Laboratory Operations, Children’s Medical Center, Dallas

"It’s obvious that Mark Graban has spent time in the trenches of healthcare and understands the complexities of applying the Lean philosophy and tools to that environment. If you want to improve your chances of surviving in today’s healthcare system (both literally and figuratively), read this book."
―Dean Bliss, Senior Lean Coach, Altarum Institute.

"Graban provides a helpful translation of the terms, practices, and tools of Lean thinking into hospitals’ everyday situations and challenges. His book illustrates Lean’s elements with many actual examples of Lean applications in typical hospital practices and procedures. Graban’s book should definitely be on the reading list for those who want to bring the benefits of lean thinking to healthcare."
―David Mann, Principal, David Mann Lean Consulting

"Lean health care is becoming a global movement. The reasons given are overrun costs, errors that compromise patient safety, time of patients wasted, and general bureaucratic inefficiency. In Lean terms the problem is how to eliminate waste. Health care is different than car making. This is true but many, many hospitals are finding the principles of the Toyota Production System apply well and are making remarkable improvements. Unfortunately the remarkable improvements are in specific areas and challenging to sustain because of a mysterious ingredient which the folks at Toyota seem to understand quite well--humans. The humans that health care exists to help also operate the system and are far from perfect. Toyota's system is actually designed to support the development of people, not to provide a quick fix set of technical solutions, and this takes time and patience. Many health care consultants have rebadged themselves as lean consultants and do not understand the real thinking behind the Toyota Production System. Mark Graban is an exception. He has worked hard to study the philosophy and stay true to the thinking of Toyota. His book is a welcome translation of the Toyota Production System into language any health care professional can understand."
―Professor Jeffrey K. Liker, University of Michigan & Bestselling Author of The Toyota Way

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