The headline in this installment is the description of Virginia Mason in an article recently published by Press Ganey Partners, a “magazine featuring best practices, viewpoints and research related to health care performance improvement,” according to Press Ganey.
Todd Sloane, editorial manager of Press Ganey Associates, profiled VM in the September/October issue of the magazine. He starts with what he describes as “a scene from the future of health care:”
On an inpatient unit, nurses work in U-shaped pods and spend almost all of their time on direct patient care. Nurses pull workstations into patient rooms, doing their charting documentation “in flow,” improving the accuracy of the chart. Nursing leaders and senior executives walk through, asking questions about how things are going. Production boards show the on-time status of the unit. Most supplies are located at the point of use. A nearby medication station has a light showing whether it is available. An electronic console shows the status of all incoming patients. Almost no steps or time are wasted.
Actually, the scene is today at Virginia Mason Medical Center in Seattle, but if health care organizations are to survive in a future of shrinking reimbursements and new demands for quality and efficiency, they should take a long, hard look at what Virginia Mason is up to …
The article covers a significant portion of the history of VM during the past decade and highlights some of the most important work including the physician compact, a new deal between doctors and the VM administration. The article also looks closely at the VM Patient Safety Alert system, an approach derived directly from a process Toyota uses on its factory floor to prevent defects from being passed down the production line.
Breakthrough work at VM in primary care flow is described as well as the work VM has done with some Marketplace Collaboratives where providers work in partnership – and directly – with employers to identify high cost medical concerns for workers. The collaborations have enabled employees to improve their health much more quickly than in the past, while saving productivity time and money for employers.
And it notes all the work essentially rests upon the management principles of the Toyota Production System, adapted to health care in the form of the Virginia Mason Production System.
Dr. Gary Kaplan, VM Chairman and CEO, tells Sloane, “Through discussions with current and former leaders at Boeing and with other manufacturing firms using Toyota, we realized that while manufacturing may seem very different superficially from health care, this management methodology could bring about reliable results in any process.”
The results on quality and efficiency have helped make VM within its market “the lowest-cost tertiary provider by a significant margin,” Kaplan says. “It is good business that has and will increasingly cause employers and health plans and individuals to choose Virginia Mason. And it allows us not to get caught up in the whole argument that we are not going to change unless the payment system changes. We can educate others, and we can advocate for better-aligned payment systems as well, but given what is going on in health care, we can’t wait on payment change to innovate.”
Sloane writes in the article: “Over the past 11 years, Virginia Mason has become the learning lab of health care transformation. Its work has shown that it is possible to achieve higher quality and safer care while lowering costs, [and] improving patient satisfaction…”.
What are some ways your work has been influenced and improved by best practices in other industries?