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Productivity Press

Health Care

Book: Transforming Health Care

Virginia Mason Medical Center’s Pursuit of the Perfect Patient Experience

Published: Wednesday, December 8, 2010 - 05:30

(Productivity Press: Boca Raton, FL) -- What does the production line at a car manufacturer have to do with a doctor scrubbing in for brain surgery?

A lot, as it turns out.

For almost 10 years, Virginia Mason Medical Center in Seattle has adopted the essential principles of the Toyota Production System in an effort to improve quality, safety, and efficiency. The results have surpassed all expectations. Virginia Mason ranks among the top 1 percent of all hospitals measured for efficiency, according to the Leapfrog Hospital Recognition Program, which compares 1,184 hospitals in 45 states. Efficiency is a Leapfrog measure that combines scores for quality and resource use—an important way of looking at value. Virginia Mason’s Chairman and CEO, Dr. Gary S. Kaplan, and the hospital itself have received numerous national awards and honors for quality of service. Hundreds of doctors, nurses, trustees, administrators, and CEOs from 31 states and eight nations have come to Seattle to see, firsthand, how the Virginia Mason Production System (VMPS) works, and the number of requests for visits continues to increase.

Published on the eve of the 10th year VMPS has been in use, and immediately following the creation of the Centers for Medicare & Medicaid Services’ new Innovation Center, Transforming Health Care: Virginia Mason Medical Center’s Pursuit of the Perfect Patient Experience (Productivity Press, 2010) is Charles Kenney’s chronicle of Virginia Mason’s dramatic transformation. From the factory floor in Japan to the halls of Virginia Mason Hospital, Kenney captures the amazing story of the application of a manufacturing method to the delivery of patient care.

What is VMPS and why does it work? The foundation of the Virginia Mason Production System is a Japanese term called kaizen—continuous, incremental improvement to eliminate the waste, inefficiency, and variation that plagues so many processes essential to the health care experience. Getting down to the brass tacks, this means:

Fewer medical errors. Inspired by Toyota’s model, every one of Virginia Mason’s 5,000 employees is now able and encouraged to stop the “assembly line” of care whenever potential harm to a patient is perceived. Since its inception, more than 15,000 Patient Safety Alerts have been called resulting in countless cases where harm was prevented.

Hearing, “Where’s my nurse? I buzzed her 20 minutes ago” a lot less often. Before the system was implemented, studies showed that nurses were spending barely one-third of their time providing direct care to patients; today, nurses spend 90 percent of their time on direct care.

The computers do more than just store records. Virginia Mason has a computerized module that sorts through electronic medical charts and automatically identifies disease management and preventive testing that is due or overdue.

Less money wasted, more money spent on new equipment and training. Professional liability insurance expenses declined at the hospital by 26 percent from 2007 to 2008 and then dropped an additional 12 percent the following year. Insurers have asked Virginia Mason to teach its safety methods to other medical centers.

At a critical moment, this book tells the story of one of the most unusual journeys in the history of American medicine. In a rousing foreword, Donald M. Berwick, MD (former president and CEO of the Institute for Healthcare Improvement, head of the Centers for Medicare & Medicaid Services, and one of the nation’s leading authorities on health care quality and improvement), writes that, “health care is hungry for something truly new—less a fad than a new way to be… Virginia Mason Medical Center… has a better shot at becoming one than almost any other large health care organization in America today. This book recounts a journey that offers an enormous dose of hope that VMMC can demonstrate the transformed results that we so badly need.”

Charles Kenney is a former writer and editor at the Boston Globe and noted author of many books, including The Best Practice: How the New Quality Movement Is Transforming Medicine, which The New York Times described as “the first large-scale history of the quality movement.’’

Gary S. Kaplan, MD, has served as chairman and CEO of the Virginia Mason Health System since 2000. He is a practicing internal medicine physician and has received national and international recognition for Virginia Mason’s work to transform health care and demonstrate that higher-quality, lower-cost health care is achievable. In 2009, Kaplan received the John M. Eisenberg Award, a national recognition for commitment to patient safety and quality; and he received the Harry J. Harwick Lifetime Achievement Award.


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Productivity Press

For more than 25 years, Productivity Press has developed the largest catalog available anywhere of publications and learning tools about lean methodology, continuous improvement, and operational excellence. It is currently the premier source of authoritative information on organizational transformation. Productivity Press is an imprint of CRC Press, a premier global publisher of science, technology, and medical resources. Its aim is to broaden thinking and advance understanding in the sciences, providing researchers, academics, professionals, and students with the tools they need to share ideas and realize their potential. CRC Press is a member of Taylor & Francis Group, an informa business.