Frontiers of Health Services Management - Spring 2013 - (Page 21)

improvement workshops, and met for a series of seminars to learn and discuss the method. We then visited a company in Hartford, connecticut, that had applied it and achieved great success. at that juncture, we were advised by leading experts that if we were serious about adapting the method to healthcare, we had to go to Japan to see the method in action and learn from the very best in the world. Overcoming Barriers to Innovation and Improvement in healthcare, multiple barriers often arise when attempting any sort of disruptive innovation. virginia Mason had long championed clinical excellence and innovation, yet we faced barriers in many checklist categories, from embedded safeguards to evidence protocols. But we knew the toughest barriers were cultural. introducing an approach as unusual as tPS into the practice of medicine generated significant resistance from many staff members, as well as incredulity in our local community. We also encountered a powerful wave of concern and negativity from a large number of doctors and other staff members within virginia Mason. as one of our surgeons, recalled, “People were saying, ‘We’re struggling financially, and all of a sudden we’ve got 30 people in Japan for a ten-day boondoggle while the rest of us are working.’” as we prepared to go to Japan, two essential elements—both noted in the ceo checklist—were apparent: leadership and the active involvement of our board of directors. leadership was demonstrated by the senior team’s willingness to accept significant criticism—both internal and external—and forge ahead with what we believed was best for virginia Mason, our staff, and our patients. and without the Ga r y S. Ka p l a n • 21 f e a t u r e rienced two consecutive years of operating losses—unheard of in its history. in addition, the world of healthcare was changing rapidly and unpredictably. virginia Mason leaders, including myself, visited other healthcare organizations around the country looking for a management method we believed would enable us to make the kind of quality and efficiency leaps that were needed. However, even after visiting a variety of prominent provider organizations, we found no existing management method in healthcare that would help us achieve our goals. Serendipitously, at this time we discovered our neighbors at Boeing had been using the toyota Production System (tPS) as their management system. When we studied Boeing’s work, we found that the company had achieved success applying tPS methods to the manufacture of its 737 line of commercial aircraft. By applying lean manufacturing principles, Boeing had reduced the production time and cost of building a Boeing 737 aircraft—according to Kenney (2010), “assembly time for the 737 was reduced from twenty-two days in 1999 to eleven days in 2005”—and built an even higher-quality, high-reliability aircraft than before implementing tPS. as we continued to study the toyota method, we learned that it had become one of the most widely used and highly reliable management systems in the world. it was largely applied to manufacturing, although some service companies relied on its tools and techniques as well. We soon realized it might also be an excellent fit in healthcare. a small team of executives at virginia Mason spent about a year delving into the method’s theory and practice. We read volumes of tPS literature, spoke to numerous experts, experimented with a few early

Table of Contents for the Digital Edition of Frontiers of Health Services Management - Spring 2013

Frontiers of Health Services Management - Spring 2013
Contents
Frontiers of Health Services Management - Spring 2013
A Management, Leadership, and Board Road Map to Transforming Care for Patients
Pursuing the Perfect Patient Experience
Adapting to the New Healthcare Market
High Reliability: Truly Achieving Healthcare Quality and Safety
Making Lean Progress Last: Why Sustaining Excellence Requires the Right Leadership Framework

Frontiers of Health Services Management - Spring 2013