“Front-line staff must know, understand, embrace and drive kaizen and its tools to achieve incremental and continuous improvements.”

- Gary S. Kaplan, MD, Chairman and CEO, Virginia Mason

Mark Graban is one of the most respected voices in the lean world. He is the founder and driving force behind Lean Blog, a vibrant site he continuously updates with compelling information and analysis about lean in health care.

Mark’s new book, Healthcare Kaizen: Engaging Front-Line Staff in Sustainable Continuous Improvements (co-authored with Joseph E. Swartz), is a must read for anyone on a lean journey.

At Virginia Mason, the concept of kaizen, which Mark and Joe write about so well in the new book, is ingrained in the organization’s cultural DNA. In writing about kaizen, Mark and Joe observe:

“This little word might be one of the most powerful words and concepts for improving healthcare processes and quality. Hospitals around the world are using this concept, often as part of a broader ‘Lean management’ initiative … hospitals and healthcare organizations can improve when we have a highly engaged workforce focused on providing value to patients and minimizing waste in the delivery of care.”

The real goal of lean in health care, they write, is cultural transformation. This is an essential insight. At Virginia Mason, the work of adapting the Toyota Production System to health care in the form of the Virginia Mason Production System has cultural transformation at its core. This sort of change is anything but easy. Culture, as the saying goes, tends to eat strategy for lunch.

But cultural change is transformative. We have experienced that change at Virginia Mason, and the results – in terms of patient safety and satisfaction, as well as overall quality and efficiency – are truly dramatic.

Gary S. Kaplan, MD, chairman and CEO, Virginia Mason, said of Mark and Joe’s new book: “Front-line staff must know, understand, embrace and drive kaizen and its tools to achieve incremental and continuous improvements. This book will help health care organizations around the world begin and advance their journey.”

Mark and Joe understand the patience required to do this work well. They recognize the power of the sort of continuous incremental improvement at the heart of the Toyota Production System. They write:

“Within the theme of continuous improvement, Kaizens tend to be small local changes at first … A Kaizen organization supplements necessary and large, strategic innovations with lots of small improvement ideas … The expectation is that a large number of small changes leads to an impressive impact to an organization’s core measures. Small changes, which can be completed more quickly than major projects, can build enthusiasm and problem-solving skills that people can then apply to larger problems.”

The book is highly detailed and includes helpful discussion questions at the end of each chapter.

At Virginia Mason, front-line staff engagement is promoted through a number of tools and methods. Among these are Everyday Lean Ideas, the organization’s idea system that incorporates the principles of the Virginia Mason Production System, and the Plan-Do-Study-Act cycle, the framework staff members across the organization use for carrying out rapid, small-scale tests of change.

How are you engaging front-line staff to make continuous improvements in your organization?