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Transforming Health Care
For decades, the manufacturing industry has employed the Toyota Production System ― the most powerful production method in the world ― to reduce waste, improve quality, reduce defects and increase worker productivity. In 2001, Virginia Mason Medical Center, an integrated healthcare delivery system in Seattle, Washington set out to achieve its compelling vision to become The Quality Leader and to fulfill that vision, adopted the Toyota Production System as its management method.
Transforming Health Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience takes you on the journey of of Virginia Mason Medical Center's pursuit of the perfect patient experience through the application of lean principles, tools, and methodology. Over the last several years Virginia Mason has become internationally known for its journey towards perfection by applying the Toyota Production System to healthcare. The book takes readers step by step through Virginia Mason's journey as it seeks to provide perfection to its customer – the patient. This book shows you how you use this system to transform your own organization.
Transforming Health Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience takes you on the journey of of Virginia Mason Medical Center's pursuit of the perfect patient experience through the application of lean principles, tools, and methodology. Over the last several years Virginia Mason has become internationally known for its journey towards perfection by applying the Toyota Production System to healthcare. The book takes readers step by step through Virginia Mason's journey as it seeks to provide perfection to its customer – the patient. This book shows you how you use this system to transform your own organization.
223 pages, Hardcover
First published November 8, 2010
24 people are currently reading
177 people want to read
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Displaying 1 - 18 of 18 reviews
June 26, 2025
I want to re-read this at some point, super interesting to see how modern day “little things” have translated across US healthcare from this initiative. Also how lean principles can be applied almost everywhere.
Not an auto-pilot book. Not textbook style, but requires being in the mood to translate complex strategies.
Not an auto-pilot book. Not textbook style, but requires being in the mood to translate complex strategies.
August 27, 2019
The idea of applying lean management to healthcare has been a contentious one, but for the past ten years, Virginia Mason has been held up as the classic example of why the historically contentious idea is a worthwhile one. The nutshell story goes, Virginia Mason took classic lean management ideas, from mapping out processes, standardizing work, and reducing waste, and led to clear improvements in clinical quality, patient experience, and financial results. This book is about how Virginia Mason pulled that off.
This boo, although published by a technical publisher, is not a technical document. Those in the healthcare field seeking out truly applicable tactical insights will be left unsatisfied. In 180 pages, it could only ever be an amuse bouche into the unsurprisingly complicated universe of lean management and healthcare. It does however, does a good job wetting one's appetite and willingness to consider the potential for lean management to be truly transformative for healthcare. Particularly illuminating were the more lucid sections on the ambulatory surgery, filled with tangible morsels. In many places the author veers away from the tangible and clear and concrete, dealing instead in meaningless aphorisms and lean manufacturing buzz words.
This boo, although published by a technical publisher, is not a technical document. Those in the healthcare field seeking out truly applicable tactical insights will be left unsatisfied. In 180 pages, it could only ever be an amuse bouche into the unsurprisingly complicated universe of lean management and healthcare. It does however, does a good job wetting one's appetite and willingness to consider the potential for lean management to be truly transformative for healthcare. Particularly illuminating were the more lucid sections on the ambulatory surgery, filled with tangible morsels. In many places the author veers away from the tangible and clear and concrete, dealing instead in meaningless aphorisms and lean manufacturing buzz words.
December 24, 2018
Really opened my eyes about what VPMS really is and why it is important/useful in any type of production.
March 21, 2023
Really opened my eyes about what VPMS really is and why it is important/useful in any type of production.
Read
March 2, 2015What Virginia Mason has done reminds me of a couple lines from the Bhagavad Gita: "What the outstanding person does, others will try to do. The standards such people create will be followed by the whole world" (3:21). Virginia Mason is probably at the evolutionary edge of system-based healthcare improvement in the U.S.A. The benefits come financially, are seen with better morale, and also manifest as happier and more satisfied patients.
One message that came through strongly is that the culture of the hospital, the ethos, must support improvement or else the whole idea is stillborn. And a few things came out that strikingly showed how the clinic culture and attitude matters:
(1) If a a patient calls a nurse, Virginia Mason considers this evidence of a mistake in the system: something went wrong, because the patient's need was not predicted and addressed before pressing the button! The excerpt: Tachibana and her team implemented a system of hourly nurse rounds as a way to get nurses to anticipate patient needs rather than react to them. She and her colleagues consider a call light to be a defect because it means the care team has failed to anticipate a patient’s needs. Under ideal conditions, anticipating a patient’s needs happens in a calm, predictable fashion. (pg 120. Bold mine)
(2) When Virginia Mason built a new Kirkland Clinic, they designed and constructed it from the ground up using their improvement philosophy and practices. The new clinic is so reliable and efficient, patients never wait when they arrive for their appointments. This sounds hard to believe, but at the new clinic, schedule reliability is so high, they didn't even build a waiting room! Excerpt: On arrival, patients skip the waiting room (there isn’t one)... (pg 91).
(3) Patients are honored by a system that includes their input. Before planning and building a new hyperbaric treatment center, the team included patients for opinions on what patients wanted and why. And they wanted something relaxing, comfortable, and pleasant. So Virginia Mason gave them just that:
Near the entrance the floor looks like wet sand and becomes ocean blue near the chamber. The chamber is blue with fish painted on the far wall outside the chamber portholes, as might be seen from underwater. The ceiling is sky blue. Naturally, a “cabana,” in nature’s greens and browns, was designed as the waiting area, complete with artificial palm trees and a saltwater aquarium. Space design is such that the ceiling height increases near the chamber, thus shrinking its visual impact. All of this happened because Hampson and his crew were able to increase value from the patients’ perspective by including them in the design process. (pg 107)
(4) Virginia Mason started learning improvement by visiting Toyota in Japan to learn from the original creators of the improvement system. Excerpt: While the Toyota facility was an inspirational stop on their trip, it was humbling, as well. The team’s work was difficult and the days long. Team members would grow somewhat tense under pressure from senseis who were unrelenting. One evening, near the end of a long and arduous day, a team led by Dr. Bob Mecklenburg, Chief of Medicine, and Charleen Tachibana, Chief of Nursing, was huddled with a sensei who had been pushing them for hours. The team was studying a schematic of a section of Virginia Mason when the sensei pointed to an area on the graphic and asked what it was. Dr. Mecklenburg told him it was a waiting room.
“Who waits there?” the sensei asked.
“Patients,” Mecklenburg said.
“What are they waiting for?”
“The doctor.”
The sensei asked more questions, learning that there were dozens and dozens of waiting rooms spread throughout the medical center—waiting rooms in every division of every department and most crowded much of the time.
The sensei reacted as though an invisible line had been crossed; as though he was deeply offended by this news. “You have one hundred waiting areas where patients wait an average of forty-five minutes for a doctor?”
He paused and let the question hang in the air, and then asked, “Aren’t you ashamed?” (pg 22 - 23)
One message that came through strongly is that the culture of the hospital, the ethos, must support improvement or else the whole idea is stillborn. And a few things came out that strikingly showed how the clinic culture and attitude matters:
(1) If a a patient calls a nurse, Virginia Mason considers this evidence of a mistake in the system: something went wrong, because the patient's need was not predicted and addressed before pressing the button! The excerpt: Tachibana and her team implemented a system of hourly nurse rounds as a way to get nurses to anticipate patient needs rather than react to them. She and her colleagues consider a call light to be a defect because it means the care team has failed to anticipate a patient’s needs. Under ideal conditions, anticipating a patient’s needs happens in a calm, predictable fashion. (pg 120. Bold mine)
(2) When Virginia Mason built a new Kirkland Clinic, they designed and constructed it from the ground up using their improvement philosophy and practices. The new clinic is so reliable and efficient, patients never wait when they arrive for their appointments. This sounds hard to believe, but at the new clinic, schedule reliability is so high, they didn't even build a waiting room! Excerpt: On arrival, patients skip the waiting room (there isn’t one)... (pg 91).
(3) Patients are honored by a system that includes their input. Before planning and building a new hyperbaric treatment center, the team included patients for opinions on what patients wanted and why. And they wanted something relaxing, comfortable, and pleasant. So Virginia Mason gave them just that:
Near the entrance the floor looks like wet sand and becomes ocean blue near the chamber. The chamber is blue with fish painted on the far wall outside the chamber portholes, as might be seen from underwater. The ceiling is sky blue. Naturally, a “cabana,” in nature’s greens and browns, was designed as the waiting area, complete with artificial palm trees and a saltwater aquarium. Space design is such that the ceiling height increases near the chamber, thus shrinking its visual impact. All of this happened because Hampson and his crew were able to increase value from the patients’ perspective by including them in the design process. (pg 107)
(4) Virginia Mason started learning improvement by visiting Toyota in Japan to learn from the original creators of the improvement system. Excerpt: While the Toyota facility was an inspirational stop on their trip, it was humbling, as well. The team’s work was difficult and the days long. Team members would grow somewhat tense under pressure from senseis who were unrelenting. One evening, near the end of a long and arduous day, a team led by Dr. Bob Mecklenburg, Chief of Medicine, and Charleen Tachibana, Chief of Nursing, was huddled with a sensei who had been pushing them for hours. The team was studying a schematic of a section of Virginia Mason when the sensei pointed to an area on the graphic and asked what it was. Dr. Mecklenburg told him it was a waiting room.
“Who waits there?” the sensei asked.
“Patients,” Mecklenburg said.
“What are they waiting for?”
“The doctor.”
The sensei asked more questions, learning that there were dozens and dozens of waiting rooms spread throughout the medical center—waiting rooms in every division of every department and most crowded much of the time.
The sensei reacted as though an invisible line had been crossed; as though he was deeply offended by this news. “You have one hundred waiting areas where patients wait an average of forty-five minutes for a doctor?”
He paused and let the question hang in the air, and then asked, “Aren’t you ashamed?” (pg 22 - 23)
June 12, 2019
A CLASSIC BOOK !
This book tells the story of the burgeoning health care quality movement, and of how the medical landscape is being radically transformed — for the better.
Good for anyone wanting a background on the history of quality improvement and some of the key players who started it all.
📖 The Best Practice How the New Quality Movement is Transforming Medicine @charlesjkenny | @public_affairs
🇻🇳 Mô hình lấy bệnh nhân làm trung tâm
#bookbag #share #HealthcareManagement
This book tells the story of the burgeoning health care quality movement, and of how the medical landscape is being radically transformed — for the better.
Good for anyone wanting a background on the history of quality improvement and some of the key players who started it all.
📖 The Best Practice How the New Quality Movement is Transforming Medicine @charlesjkenny | @public_affairs
🇻🇳 Mô hình lấy bệnh nhân làm trung tâm
#bookbag #share #HealthcareManagement
October 28, 2014
There are those who think America has the best health care system in the world, and that it is excellent in its own right. If they wanted evidence that the America was not the best in the world, they would read T.R. Reid's, The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care, which points out the many downsides of America's health care system. But even if it was accepted that America was not "#1" in the world, there is still the presumption that the system is running very well. This book shows conclusively that is not the case. Take an already highly regarded medical center. Turn it upside down, and show massive, consistent improvements in patient care, patient satisfaction, cost reductions, staff satisfaction, and on and on. If they were at "excellent" before, what are they now? And since the new system is based on "constant improvement", what will they be in the future? This book shows the process for "transforming" health care, warts and all, thoroughly, succinctly, and, dare I say, entertainingly. Forget Obamacare and how America compares to the world. Read this book and find out all American's have probably been missing, at least, up to now. Highly recommended.
June 18, 2012
I continue my struggle to find how to best engage this health-care behemoth.
I find the themes in the book appealing and speak to some underlying principles which I endorse re redistribution of resources/philosophy to streamlining efficiency.
It fails for me in that it meets Goliath not as David but a powerful organization with tremendous resources and financial reserves. I think it also falls into the same traps of many current models in that it seems to attribute success to process optimization rather than the tenets which allowed this.
I believe these unifying principles to be the presence of passionate engaged champions and a mathematical tipping point in population where specialization trumps generalization.
Unfortunately the latter limits generalization to smaller organizations in a manner akin to why Newtonian physics works well at a planetary level but not at a particle level. Probabilistic phenomenon are noise in large samples and mean distributions often define populations. Probabilistic approach and necessary adaptability being the better model I suspect for small organizations.
One step closer in trek...
I find the themes in the book appealing and speak to some underlying principles which I endorse re redistribution of resources/philosophy to streamlining efficiency.
It fails for me in that it meets Goliath not as David but a powerful organization with tremendous resources and financial reserves. I think it also falls into the same traps of many current models in that it seems to attribute success to process optimization rather than the tenets which allowed this.
I believe these unifying principles to be the presence of passionate engaged champions and a mathematical tipping point in population where specialization trumps generalization.
Unfortunately the latter limits generalization to smaller organizations in a manner akin to why Newtonian physics works well at a planetary level but not at a particle level. Probabilistic phenomenon are noise in large samples and mean distributions often define populations. Probabilistic approach and necessary adaptability being the better model I suspect for small organizations.
One step closer in trek...
November 24, 2013
Very thought provoking. Great to read a management book on Lean(or TQM, or) that's set in a context other than manufacturing. Practitioners need to see more examples set in service and other areas (such as administration).
What really stands out about the Virginia Mason example is the vital role of leadership - coming from the top (CEO, President), and even the board of directors. How very unusual, but so effective.
What really stands out about the Virginia Mason example is the vital role of leadership - coming from the top (CEO, President), and even the board of directors. How very unusual, but so effective.
June 11, 2014
This is a really excellent book. It overviews the real life development of a major medical facility as it occurred specialty by specialty and by professional area.
A must read for anybody who is looking for lessons, techniques ideas and strategies that can be used to improve healthcare services.
I particularly liked the focus on the improving the patient experience as the driver for change
A must read for anybody who is looking for lessons, techniques ideas and strategies that can be used to improve healthcare services.
I particularly liked the focus on the improving the patient experience as the driver for change
March 31, 2013
Inspiring and informative story. Should have focused more on financials and relied upon a more diverse set of sources, which were almost exclusively the executives responsible for the success of the changes the hospital made. A must-read, though, for those in health care.
July 21, 2013
Virginia Mason Hospital has moved far ahead of most hospitals in terms of the quality and efficiency of the health care it provides. The book in my opinion shows the rest of the health care world where we should be heading. Clearly written and researched. Jim
November 18, 2013
Accessible, easy read. Should be mandatory reading for anyone who has chosen to dedicate their life to working within the American clinical medical system.
April 23, 2014
Really disappointing. VM are held up as an amazing example to us all. However this book has no charts or dates examples. Numbers are quoted but not backed up. Maybe my expectations were too high.
December 10, 2014
Great insights into how to improve. The chapter on improved OR turnarounds resonated with me. All about looking at the overall process and making it better serve the needs of patients.
April 9, 2015
The most notable thing about this book is the research questions I've fielded years later. I'm left wondering, "why not sooner?" Also, this was a slog. SO FREAKING BORING.
November 30, 2011
Great examples of how to change a culture!
April 14, 2017
A good overview of the amazing achievements made by using the TPS in a healthcare settings.
Displaying 1 - 18 of 18 reviews