Premium Essay

Lean Hospitals

In: Business and Management

Submitted By macias
Words 89990
Pages 360

“Mark Graban’s book has documented what is now happening in hospitals all across
America as we learn to apply the Toyota Production System methodology to healthcare.
This book lays out the nuts and bolts of the lean methodology and also describes the more difficult challenges, which have to do with managing change. Graban’s book is full of wins—these are the same type of wins that are happening at ThedaCare every day. I wish
I could have read this book six years ago, as it might have prevented some of the mistakes we made in our lean transformation journey.”
— John S. Toussaint, MD, President/CEO ThedaCare Center for Healthcare Value
“Coupled with a foundation of alignment and accountability, the ideas in this book provide a powerful tool to help hospitals get closer to the goal we want – perfect care.”
— Quint Studer, CEO, The Studer Group, author of Results that Last
“Mark Graban is the consummate translator of the vernacular of the Toyota Production
System into the everyday parlance of healthcare. With each concept and its application, the reader is challenged to consider what is truly possible in the delivery of healthcare if 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 are promised and what we actually get. Mark Graban explains how those in the system can make care delivery better for everyone –patients, providers, and payers.”
— Steven Spear, Senior Lecturer, MIT, Senior Fellow, IHI
“Mark Graban’s work has been a steady companion in the three years I have been studying and applying lean in healthcare. He...

Similar Documents

Premium Essay

Hospitals Drive in Lean Organizations

...Case study # 1: Hospitals are driving toward a leaner organization Case study # 1 1. The best perspective of organizational effectiveness that describes the application of lean management practices is organizational learning perspective. This perspective focuses on the most value input as known as knowledge. Organizational learning is founded on the idea that organizational effectiveness depends on the organization’s capacity to acquire, share, use, and store valuable knowledge (Mcshane & Von Glinow, 2012). Sunderland Royal hospital engages in organizational learning perspective through learning lean management from external knowledge. Sunderland’s employees took tour at Nissan Factory to acquire and share knowledge from Nissan work plant, and later they applied and stored knowledge in their work unit. Employees always play critical role in this process and they are important intellectual capital of learning organizations. They can use and share knowledge through the process by mapping out their work process and identifying ways to reduce waste process. As Sunderland’s employees discovered ways to reduce average patient’s wait time, they can improve efficiency and quality service. Also, many other health care around the world apply lean management in their organization by receiving lean training from Japan. Flinders Medical center also learned and adopted lean knowledge after seeing South Australian Medical Facility experienced problem of overload patients in its......

Words: 680 - Pages: 3

Free Essay

The Affordable Care Act (Aca) and Hospital Compliance

...the healthcare system and hospitals must adapt accordingly or face dire financial challenges. Some of the financial challenges will originate from the influx of Medicaid patients due to the Medicaid expansion. Based on these changes, there is an increased tendency for hospitals to engineer ways to reduce costs such as patient selection and staff reduction. However, for a hospital to participate in Medicare, which accounts for more than 50% of hospital budgets, certain laws and regulations must be followed. This paper discusses these laws and regulations and offers suggestions on how to adjust successfully to the upcoming changes. The Affordable Care Act (ACA) and Hospital Compliance In light of the current changes in the healthcare industry, it is imperative for every healthcare organization to adapt accordingly or face dire financial challenges. A major change included in the Affordable Care Act (ACA) is the expansion of Medicaid, which will provide coverage to millions of formerly uninsured US citizens and permanent residents (Rosenbaum, 2011). However, Medicaid is notorious for much lower reimbursement compared to Medicare and private/commercial insurance (M. Schmitt, personal communication, October 7, 2013). In addition, hospitals are now required to prove that the services they bill for actually improve and maintain patients’ health (Leonard, 2013). Hospitals are also required to cover the cost of medical errors and hospital-acquired infections......

Words: 1541 - Pages: 7

Premium Essay

Healthcare Ecosystems

...Healthcare Ecosystems Barnes Jewish Hospital is the combination of The Jewish Hospital of St. Louis built in 1902 and Barnes Hospital built in 1914. The two hospitals were combined in a merger in 1996 becoming Barnes-Jewish Hospital. Barnes-Jewish Hospital is located in St. Louis, Missouri in the Central West End neighborhood. What started off as a small Jewish hospital in 1902 is now one of the best hospitals in Missouri. It is also the largest private employer of St. Louis with 9,215 employees ( Barnes Jewish is a teaching hospital that has been associated with Washington University College of Medicine since before 1914. This association guaranteed that the hospital would be staffed with university professors and be a learning environment for cutting edge medicine. Impact on Growth Immigration had a large impact on the growth of The Jewish Hospital of St. Louis. The hospital was built with money from the Jewish community and the board of directors consisted of the city’s Jewish leaders but they wanted the hospital to help everyone. The board promised that the hospital would “afford medical and surgical care and nursing to sick or disabled persons of any creed or nationality” ( Over 3 million Jews immigrated to the United States from Europe from 1881 to 1920. The immigration was caused by economic conditions and discrimination that radiated throughout Europe......

Words: 1612 - Pages: 7

Premium Essay

Qi Plan Part 3

...QI Plan – Part I Kittitas Valley Community Hospital (KVCH) is a progressive, critical access hospital that provides exceptional health care to Kittitas County and surrounding areas. KVCH provides 24-hour emergency care and offers inpatient and outpatient hospital services. KVCH's emergency department is designated as a Level IV trauma service by the State of Washington Department of Health and is staffed 24-hours-a-day by an emergency physician (About KVCH, 2012). Over the course of this paper the types of care that KVCH focuses on, the organizations mission and their QI goals will be described as well as the role of consumers in the organizations QI process. Performance Measurement vs. Quality Improvement Processes According to the operations performance measurement program, “Performance measurement is the use of statistical evidence to determine progress toward specific defined organizational objectives. This includes both evidence of tangible fact, such as measurement of hospital acquired infections, and measurement of customer perception, such as would be accomplished through a customer satisfaction survey. In a service industry such as health care, the performance measurement process starts by defining precisely the services that the organization promises to provide, including the quality or level of service (e.g. timeliness, reliability, etc.) that is to be delivered” (Performance Measurement Fundamental, 2011). Quality improvement processes main goal is to......

Words: 732 - Pages: 3

Premium Essay

Research Methods: Akron Children’s Hospital

...(2008) provided a comprehensive case study that involves a children’s hospital called Akron Children’s Hospital, which is one of the largest pediatric care provider with 253 beds. This hospital was founded in 1890 and offers close to This hospital was founded in 1890 and offers several areas of practice all geared towards children. Akron Children’s Hospital operates in the shadows several other competitors that are also recognized nearby: Rainbow Babies and Children’s Hospital as well as the Cleveland Clinic. Cooper & Schindler (2008) stated that even though Akron Children’s Hospital is large and well regarded, it is overshadowed by its competitors. The hospital needs a communication strategy in order to distinguish itself and to strengthen its commitment to the children as well as the high-quality advanced care that it provides. The hospital also must find out the criteria that parents use in order to decide which hospital to use for their children if acute care services are needed. Expanding its market beyond Cleveland should also be something that the hospital should explore. The issue that Akron Children’s Hospital is experiencing is the fact that it does not know which strategies to use in order to expand and overshadow its competitors. While Akron Children’s Hospital is one of the largest pediatric care providers with 253beds, it lacks the strategies in which to compete in its market. The hospital is over shadowed by two other competitors and cannot......

Words: 1359 - Pages: 6

Premium Essay

The Healing Hospital

...Healing Hospital Introduction Health care delivery has always centered on holistic approach to patient care and all nursing education revolves around this concept of comprehensive nursing care and delivering a holistic nursing care to the patient. Addressing the patient as a whole not only means curing his disease but also respecting his social, physical, cultural and spiritual values. Healing hospitals are built keeping this in mind. Every human being is religious in one way or the other and leans on to the hope that his God will surely give him deliverance from this physical ailment’s hospital environment should facilitate this. Components of a Healing Hospital According to Chapman 2007 the healing hospital is a concept that more than anything else, it supports the culture of caring. Therefore love is the core of healing. A healing hospital is built on the olden belief that love is at the center of healing. The Healing Hospital represents a vision of true quality built on the most important belief of human existence- loving one another (Chapman, 2007). Their idea is supporting a strong background of caring for their patients and caregivers. Healing Hospitals employ the three symbols of loving services which are: 1. A Golden Thread that symbols faith in god to represent positive tradition of healing, 2. A pair of intersecting circles that symbolizes hope that flow into and out hearts when we experience loving encounters 3. The red heart that symbolizes love.......

Words: 942 - Pages: 4

Premium Essay

Activity Based Costing Model

...and his team failed to take seasonality into consideration. Two weeks in January are surely not representative of an entire year, especially in terms of patient volume; thus annualizing two weeks data is an obvious error. I would expect the patient volume to be lower than average in January as it is not a peak of cold/flu season and patients prefer to have their annual checkups during warmer seasons (mind you the hospital is in Massachusetts). This hunch is confirmed by analysis of the data in Exhibit 8: if we take values for Physician Visits/Year, combined NP – Patient & Employee Visits/Year and Intern/Resident Visits/Year and convert them to Visits/Day (taking into account that there are 8 Physicians, 1 Nurse Practitioner and 13 Interns/Residents at the clinic) we will get values of 5.3, 5.7 and 1.0 Visits/Provider/Day, which are very low (48 work weeks/year and 5 days/week work schedule assumed). Therefore, either PCU is overstaffed or more representative time span should be taken. Another factor that Oakley’s team overlooked is the fact that the teaching hospitals receive direct and indirect Graduate Medical Education payments from Medicare that partially compensate for residency education costs and for higher patient care costs due to presence of teaching programs. According to Donald A. Young et al, the authors of “Medicare and the American Health Care System: Report to the Congress” (June 1997, ISBN: 9780788146763), in fiscal year 1995, the average “per resident”......

Words: 577 - Pages: 3

Premium Essay

History of Hospitals

...Hospitals originated in the 17th century primarily as an institution to provide housing and basic healthcare for the poor. It provided a haven to quarantine individuals to prevent the spread of highly contagious diseases. The technologies and vaccinations available did not allow for the comprehensive care we rely on today. Those who could afford clinical care would pay doctors and nurses to provide services in their home. In the early 19th century, as industrial cities became more populated, the demand for clinical and institutional care grew. Medical technology and scientific innovation made ambulatory healthcare available, yet there was not enough capital to support building large institutions viable to facilitate it. Religious organizations, philanthropists, and local governments built private and public institutions designed to deliver ambulatory, inpatient, and emergency care to local populations. By the beginning of the 20th century, hospitals became capable for research, development, and scientific discovery. Facilities became very large, housing and treating patients as well as facilitating medical research. Modern hospitals now provide clinical care to the most complex and critically ill patients while researching, innovating, and advancing medical technology. With increasing demand for treatment of chronic care, as well as the advancements in acute ambulatory care, modern hospitals have integrated vertically and horizontally to diversify their brand and provide......

Words: 710 - Pages: 3

Premium Essay

Qi Wk 1

...facilities is to have a reputation of providing the highest quality of care to the patients. Maintaining and continuously striving to improve the quality of various processes and procedures within the facility is important. Foundation frameworks, stakeholder differences, roles of clinicians and patients, need for quality management, areas to monitor, regulatory agencies, and resources represent the various points that will be addressed throughout the paper. Foundational Frameworks of QI There are several foundational frameworks within the subject of QI. There are several QI models derived from ideas and theories of leaders. According to Ransom, Joshi, Nash, and Ransom, (2008) PDSA/PDCA, API, FOCUS PDCA, Baldrige Criteria, ISO 9000, Lean, and Six Sigma represent various frameworks used to improve the quality of healthcare. Edward Deming described the Plan-Do-Study-Act (PDSA) cycle a plan to learn and improve the quality of work dated back to 1950s. Later Walter Shewhart developed the Plan-Do-Check-Act (PDCA) cycle for the basis for planning and expressing QI endeavors. The PDSA/PDCA model helps the facility to focus on how to plan for the improvement, how the improvement will be implemented, how the improvement will be identified/monitored, and what was learned from the improvement process. The associates in process improvement (API) represent a model based upon the PDSA cycle. In addition to the PDSA cycle the model adds three fundamental questions: what are we trying...

Words: 1073 - Pages: 5

Premium Essay

Quality Plan Part I

... MSN, BSN, RN, C QI Plan Part I For more than a decade, Via Christi has sponsored a variety of initiatives designed to improve the quality of care provided. These efforts have engaged staff, patients and physicians at all levels within the hospital to measure and improve the quality and safety of patient care. At times these initiatives have seen success and failures, but with the recent push for our “big aim” quality is the major focus. The physicians, nurses, other clinicians and administrative leaders overwhelmingly agreed that Via Christi should adopt the goal of reducing serious safety events by 80 percent over the next three years. Performance Measurement and Quality Improvement Performance measurement is known as the collecting and analysis of data to determine how an organization will reach its potential (The Joint Commission, 2013). Often this type of analysis is seen in engineering, with the recent push in Via Christi, Lean design and Six Sigma black belts have joined the team in quality. A good example of performance measurement is through The Joint Commission. They have outlined a set of performance development methodology that is considered the "gold standard" in health care today. By meeting these measure hospitals can function at an optimal level regarding quality care. “Quality improvement consists of systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups” (U.S.......

Words: 887 - Pages: 4

Premium Essay

Hospital Efficiency

...organizational effectiveness best describe the application of lean management practices? Describe how specific elements of that perspective relate to the interventions described in the case study. The case study in question shows many benefits of hospitals around the world adapting to lean management practices. Essentially they are looking to cut waste, and provide the most efficient care possible. The first perspective of organizational effectiveness the hospitals are utilizing is an organizational learning perspective. The hospitals have identified in their studies that several sources of capital influence their effectiveness. Specifically, human and structural capitals are being utilized to benefit the organization. “Lean works because it is based on doctors, nurses, and other staff leading the process and telling us what adds value and what doesn’t. They are the ones who know.” (McShane (2012). Organizational Behavior: Case Study 1.1. McGraw-Hill). Here, an emphasis is placed on human capital, and the knowledge, experience, and know-how hospital employees bring to the process. By bringing these individuals into the decision making process who have their hands in the work day in and day out, the outcome will be a more efficient, and smoothly running operation as evidenced by the case study. Building on the human capital used, the hospitals are also using a high performance work practice perspective. The hospital is packaging together the best use of their......

Words: 658 - Pages: 3

Premium Essay

Organizational Systems Task 1

...improved patient safety and satisfaction. Maybe with an understanding of dementia the patient could have been reoriented, medicated, moved to a room across from the nurses desk, or had a CNA sit with the patient to prevent the need for restraints. If the patient was drowsy there is a good chance the restraints in this case were not medically indicated. Dementia patients are more prone to weight loss and inadequate nutrition which could lead to other risk. In this case the staff should have offered a variety of foods the patient like to help maintain adequate nutrition (Sauls, 2013). B. Quality patient care Hospitals uses nursing-sensitive indicators on an institutional level to improve the quality of patient care. Hospitals have quality improvement departments that collects data using different approaches and models of quality improvement, such as Lean, Six Sigma, and the Plan-Do-Study-Act model, to...

Words: 740 - Pages: 3

Premium Essay

Healthcare Marketing Analysis

...January 08, 2012 Health Care Marketing Analysis Grady Memorial Hospital commonly known as Grady Hospital located in the state of Georgia opened in 1892. “Grady Health System was created by and named for Henry W. Grady, editor of the "Atlanta Constitution," who worried about the lack of quality health care for Atlanta's poor” (Grady, 2010, p. 1). Grady Hospital is the largest public hospital in Atlanta with a specialization in trauma treatment. Grady hospital previously practiced racial discrimination by separating the African American patient from White patients thereby receiving the segregated name of “The Gradys.” Although Grady abolished the historic segregation, some elderly residents of Atlanta, and African American residents still refer to Grady as a hospital “segregated evenly between white and black wards” (Burns, 2011, p. 1). However, despite the alleged racial profiling Grady hospitals mission consist of serving poor Atlanta resident “while rising healthcare costs and the economic downturn threatened its solvency a few years back along with serving patients who can't get care elsewhere” (Burns, 2011, p. 1). The public recognized Grady Hospital as one of the premier hospitals in the Southern United States that provides trauma care to accident victims, fall victims, patients suffering from self-inflicted harm, and assault victims. Four P’s of Marketing Grady is a teaching hospital accredited by The Joint Commission that “shows patient care......

Words: 1542 - Pages: 7

Premium Essay

Human Behavior in Organizataion

...Analysis: 1.1 Hospitals are Driving toward a Leaner Organization Background: To obtain sustainable organizational efficiency and service quality, many hospitals have adopted an Open Systems Perspective by using “lean management” procedures borrowed from leading car manufacturers, in an effort to “reduce and remove waste from work processes”. These processes improved organizational efficiency reduced costs and provided better patient care. i What ‘seems’ to be the Problem: Secondary Symptoms Full waiting rooms, long wait times, inefficient use of supplies and budgets, needless stress and high mortality rate is feedback from the external environment that the hospitals are not meeting the needs of their stakeholders, or fitting in with their environment. Before adapting lean management processes, hospital staff and patients alike shared the burden of what appeared to be the inevitable consequences of health care delivery and a closed systems perspective.ii These problems are manifestations of organizational deficiencies which negatively affect the quality of patient care, the distribution of hospital resources and employee morale. The Real Reasons Hospitals are Facing Difficulties: Primary Problems The secondary symptoms are indicative of underlying issues, highlighting their poor organizational-environmental fitiii and the ineffectiveness of communication between Internal Subsystems.iv To a large extent hospitals have not adapted to their external environment nor have hospitals......

Words: 1413 - Pages: 6

Free Essay

Uses of Statistical Information

...improvement plans involve patient and staff satisfaction and safety protocols (such as the use of restraints and number of patient falls). Statistics are also used to determine how many cases of particular diseases there are in the hospital, to estimate incidence and prevalence and number of deaths in the hospital. Each unit is thorough with evaluating outcomes by performing a pre-test, audit on the charts, and a post-test along with another audit. Statistics Used Descriptive statistics are used in the workplace to describe and share specific data to get information, but not draw any conclusions. According to Bennett, Briggs, and Triola (2009), "descriptive statistics deals with describing raw data in the form of graphics and sample statistics" (p. 7). Some examples of descriptive study currently in place in a variety of areas are emergency room wait times, the number of homeless veterans being cared for and numbers of readmissions in the hospital. Wait times for the emergency room are averaged through the computer system from the time the patient checks into the time the patient is seen. The information collected is the age and ethnicity of the individual, and the amount of time spent waiting for care. This information is used within the hospital in improve patient care and patient satisfaction. Homeless Veterans are an immensely vulnerable population in the local community. The data collected on these patients are their ethnicity, age, social status, completed education......

Words: 978 - Pages: 4