“I have been in leadership in health care for about eight years, most of that in Connecticut. And in my position at Virginia Mason I have learned more in one year about being a true leader than I had in all seven years before this.”
- Rea Berg, RN
A few years ago, the number of U.S. provider organizations adapting the Toyota Production System (TPS) as their management method was miniscule. There are many more now, but the approach is still very much the exception rather than the rule.
The idea of using a management method that enables providers to reduce waste, offer greater access, and better quality and affordability is a powerful draw for a growing number of clinicians.
Michael Ingraham, MD, a hospitalist who also works as part of the Graduate Medical Education faculty for internal medicine at Virginia Mason, has seen some green shoots in this area.
“I’ve been doing interviews with applicants for our residency program and it’s amazing that a number of these young men and women seek us out because of our reputation with lean management,” Dr. Ingraham says. “They have a deep interest in quality improvement.’’
Some of these applicants have a business background and possess familiarity with the power of TPS in many different industries. “These are applicants drawn here based on the fact that we have developed the Virginia Mason Production System (VMPS), and they are looking to gain experience as a result of their training here,” Dr. Ingraham says. “They don’t have hands-on lean experience and they are looking for that here.”
These residents make the conscious decision not to go to a large academic medical center where, as Dr. Ingraham puts it, “they may have quality improvement or safety activities but many don’t have a methodology other than very rudimentary things like PDSA (Plan-Do-Study-Act). And they definitely don’t have lean.” (At Virginia Mason, lean can be defined as having the resources needed when they are needed, in just the right quantity, and at just the right time, to achieve 100 percent quality and service expectations the first time.)
Catherine Potts, MD, Chief of Primary Care at Virginia Mason, puts it this way: “When I am interviewing doctors for positions here, I talk about how our management method has made our patients so safe and that really resonates with doctors. Nobody wants to make a mistake, ever. Mistakes are so devastating for patients clearly, but also for physicians. So with our management method, it doesn’t take very long before people realize how much safer everything is. And that is a real help for me in recruiting the best people because it’s hard to sell change without compelling proof that it really works.”
And there are people who seek an interview with Dr. Potts who say, “I have read all about you guys and I want to come here because of what you are doing with lean health care.”
When Rea Berg, RN, relocated from Connecticut to Seattle a little more than a year ago, her extensive health care experience made her an attractive job candidate. She looked into positions at a variety of provider organizations but decided on Virginia mason because of VMPS.
“It is the management method and all it enables us to do that attracted me here,” she says. “I had to make a decision on where to go, and the VMPS process helped me make my decision. It was not a difficult decision.”
Berg serves manager of nursing resources, a job in which she juggles a variety of supervisory challenges. The complexity and demands of the job have been made easier because she has been through the VMPS for Leaders program, a rigorous course studying lean tools and methods.
“I have been in leadership in health care for about eight years, most of that in Connecticut,” she says. “And in my position at Virginia Mason I have learned more in one year about being a true leader than I had in all seven years before this.”
She says the team-based nature of working at Virginia Mason aligns everyone around the same set of goals and keeps the focus on patients. “And there is a huge difference between other places I have worked and here where you get the kind of support you need as a leader to ensure that our patient care is excellent”
“At Virginia Mason there is a real sense of teamwork,” Berg says. “What is really great is you never feel you are doing anything alone.”
How does your organization use lean as a draw to get the best talent?