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Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement, Second Edition
 
 

Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement, Second Edition [Paperback]

Mark Graban (Author)
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Book Description

November 7, 2011 1439870438 978-1439870433 2

Building on the success of the Shingo Prize-Winning first edition, Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement, Second Edition explains how to use the Lean management system to improve safety, quality, access, and morale while reducing costs. Lean healthcare expert Mark Graban examines the challenges facing today’s health systems, including rising costs, falling reimbursement rates, employee retention, and patient safety.

The new edition of this international bestseller begins with an overview of Lean methods. It explains how Lean practices such as value stream mapping and process observation can help reduce wasted motion for caregivers, prevent delays for patients, and improve the long-term health of your organization. In addition to a new introduction from John Toussaint, this updated edition includes:

  • New and updated material on identifying waste, A3 problem solving, employee suggestion management, and strategy deployment
  • New case studies—including a new Kanban case study (Northampton General Hospital) and another that ties together the themes of standardized work, Kanban, 5S, visual management, and Lean leadership for the prevention of patient harm
  • New examples and updated data throughout, including revised chapters on patient safety and preventing medical errors

Detailing the steps needed for a successful transition to a Lean culture, the book provides the understanding of Lean practices—including standardized work, error proofing, root cause problem solving, and daily improvement processes—needed to reduce common hospital errors. The balanced approach outlined in this book will guide you through the process of improving quality of service while reducing costs in your hospital.

*The Lean Certification and Oversight Appeals committee has approved Lean Hospitals as recommended reading for those in pursuit of Lean Bronze Certification from SME, AME, Shingo Prize, and ASQ.

Check out a video of Mark Graban discussing the new edition of his Shingo Prize-Winning Book.

http://youtu.be/0S6wVpkvjJk


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Editorial Reviews

Review

Praise for the New Edition of this Shingo Prize Winner:

Whether it is the ThedaCare story … Seattle Children’s … or Virginia Mason, the answer is in: Lean works. The question now for all of you is how are you going to do it? What is the leadership model required? … There will be many questions, and I believe starting with Mark Graban’s updated book Lean Hospitals is a good first step. … This book lays out the nuts and bolts of the Lean methodology and describes the more difficult challenges, which have to do with managing change. … I wish I could have read this in 2004, as it might have prevented some of the mistakes we made in our Lean transformation journey.
John Toussaint, MD, CEO, ThedaCare Center for Healthcare Value

 Praise for the First Edition:

Leaders of today’s healthcare organizations are on a continuous journey to improve results, requiring a relentless focus on improving the underlying process of care delivery and leadership practices. Mark has written a book that provides compelling ideas to help create better places to work, practice medicine and receive safe, high quality care.
—Quint Studer, Founder and CEO of Studer Group, a 2010 recipient of the Malcolm Baldrige National Quality Award, Author of Hardwiring Excellence: Purpose, Worthwhile Work, Making a Difference and Results That Last: Hardwiring Behaviors That Will Take Your Company to the Top

Mark Graban is the consummate translator of the vernacular of the Toyota Production System into the everyday parlance of health care. With each concept and its application, the reader is challenged to consider what is truly possible in the delivery of health care if only standardized systems borrowed from reliable industries, were implemented. Graban provides those trade secrets in an understandable and transparent fashion.
—Richard P. Shannon, MD, Frank Wister Thomas Professor of Medicine, Chairman Department of Medicine, University of Pennsylvania School of Medicine

There is an enormous shortfall between the healthcare we receive and what we actually get. Mark Graban explains how those in the system can make care delivery better for everyone –patients, providers, and payors.
—Steven Spear, Sr. Lecturer at MIT Sloan School of Management and Sr. Fellow at IHI, Author of The High Velocity Edge

Mark Graban has been tirelessly studying the application of LEAN to health care, with an emphasis on respect for the people served by the system as well as the people who provide excellent care. He has an accurate sense of how things work in health systems, which makes his work more meaningful for people who want to make them better.
—Ted Eytan, MD

The concepts outlined in this book are the most powerful tools that I have ever encountered to foster innovation, ownership, and accountability at the front line staff level. This is a must-read for any leader in today’s increasingly complex healthcare industry.
—Brett Lee, PhD, FACHE, SVP of Health System Operations at Children's Healthcare of Atlanta

The Lean approach to healthcare, including a strong emphasis on culture, is the best way to ensure the optimal patient experience. The multiple examples of the application of Lean given in this book provide a wealth of information to draw from for a hospital that is venturing into Lean principles for the first time. In addition, this book emphasizes not only methodology, but also the cultural changes that must occur for sustainability - something often forgotten in change management.
—Beverly B. Rogers, MD, Chief of Pathology, Children’s Healthcare of Atlanta, Clinical Professor of Pathology, Emory University School of Medicine

Finally! The healthcare industry has needed this book for many years. Informative, understandable, and timely, Mark Graban’s book will leave you with an appreciation for what lean is and what it can do for your hospital. After you read this book, I’ll be surprised if you don’t make implementing lean your highest strategic priority.
—Jim Adams, Senior Director, Laboratory Operations, Children’s Medical Center, Dallas

It’s obvious that Mark Graban has spent time in the trenches of healthcare and understands the complexities of applying the Lean philosophy and tools to that environment. If you want to improve your chances of surviving in today’s healthcare system (both literally and figuratively), read this book.
—Dean Bliss, Senior Lean Coach, Altarum Institute.

Graban provides a helpful translation of the terms, practices, and tools of Lean thinking into hospitals’ everyday situations and challenges. His book illustrates Lean’s elements with many actual examples of Lean applications in typical hospital practices and procedures. Graban’s book should definitely be on the reading list for those who want to bring the benefits of lean thinking to healthcare.
—David Mann, Principal, David Mann Lean Consulting

Lean health care is becoming a global movement. The reasons given are overrun costs, errors that compromise patient safety, time of patients wasted, and general bureaucratic inefficiency. In Lean terms the problem is how to eliminate waste. Health care is different than car making. This is true but many, many hospitals are finding the principles of the Toyota Production System apply well and are making remarkable improvements. Unfortunately the remarkable improvements are in specific areas and challenging to sustain because of a mysterious ingredient which the folks at Toyota seem to understand quite well--humans. The humans that health care exists to help also operate the system and are far from perfect. Toyota's system is actually designed to support the development of people, not to provide a quick fix set of technical solutions, and this takes time and patience. Many health care consultants have rebadged themselves as lean consultants and do not understand the real thinking behind the Toyota Production System. Mark Graban is an exception. He has worked hard to study the philosophy and stay true to the thinking of Toyota. His book is a welcome translation of the Toyota Production System into language any health care professional can understand.
—Professor Jeffrey K. Liker, University of Michigan & Bestselling Author of The Toyota Way

Review

Praise for the New Edition of this Shingo Prize Winner:

Whether it is the ThedaCare story … Seattle Children’s … or Virginia Mason, the answer is in: Lean works. The question now for all of you is how are you going to do it? What is the leadership model required? … There will be many questions, and I believe starting with Mark Graban’s updated book Lean Hospitals is a good first step. … This book lays out the nuts and bolts of the Lean methodology and describes the more difficult challenges, which have to do with managing change. … I wish I could have read this in 2004, as it might have prevented some of the mistakes we made in our Lean transformation journey.
John Toussaint, MD, CEO, ThedaCare Center for Healthcare Value

 Praise for the First Edition:

Leaders of today’s healthcare organizations are on a continuous journey to improve results, requiring a relentless focus on improving the underlying process of care delivery and leadership practices. Mark has written a book that provides compelling ideas to help create better places to work, practice medicine and receive safe, high quality care.
—Quint Studer, Founder and CEO of Studer Group, a 2010 recipient of the Malcolm Baldrige National Quality Award, Author of Hardwiring Excellence: Purpose, Worthwhile Work, Making a Difference and Results That Last: Hardwiring Behaviors That Will Take Your Company to the Top

Mark Graban is the consummate translator of the vernacular of the Toyota Production System into the everyday parlance of health care. With each concept and its application, the reader is challenged to consider what is truly possible in the delivery of health care if only standardized systems borrowed from reliable industries, were implemented. Graban provides those trade secrets in an understandable and transparent fashion.
—Richard P. Shannon, MD, Frank Wister Thomas Professor of Medicine, Chairman Department of Medicine, University of Pennsylvania School of Medicine

There is an enormous shortfall between the healthcare we receive and what we actually get. Mark Graban explains how those in the system can make care delivery better for everyone –patients, providers, and payors.
—Steven Spear, Sr. Lecturer at MIT Sloan School of Management and Sr. Fellow at IHI, Author of The High Velocity Edge

Mark Graban has been tirelessly studying the application of LEAN to health care, with an emphasis on respect for the people served by the system as well as the people who provide excellent care. He has an accurate sense of how things work in health systems, which makes his work more meaningful for people who want to make them better.
—Ted Eytan, MD

The concepts outlined in this book are the most powerful tools that I have ever encountered to foster innovation, ownership, and accountability at the front line staff level. This is a must-read for any leader in today’s increasingly complex healthcare industry.
—Brett Lee, PhD, FACHE, SVP of Health System Operations at Children's Healthcare of Atlanta

The Lean approach to healthcare, including a strong emphasis on culture, is the best way to ensure the optimal patient experience. The multiple examples of the application of Lean given in this book provide a wealth of information to draw from for a hospital that is venturing into Lean principles for the first time. In addition, this book emphasizes not only methodology, but also the cultural changes that must occur for sustainability - something often forgotten in change management.
—Beverly B. Rogers, MD, Chief of Pathology, Children’s Healthcare of Atlanta, Clinical Professor of Pathology, Emory University School of Medicine

Finally! The healthcare industry has needed this book for many years. Informative, understandable, and timely, Mark Graban’s book will leave you with an appreciation for what lean is and what it can do for your hospital. After you read this book, I’ll be surprised if you don’t make implementing lean your highest strategic priority.
—Jim Adams, Senior Director, Laboratory Operations, Children’s Medical Center, Dallas

It’s obvious that Mark Graban has spent time in the trenches of healthcare and understands the complexities of applying the Lean philosophy and tools to that environment. If you want to improve your chances of surviving in today’s healthcare system (both literally and figuratively), read this book.
—Dean Bliss, Senior Lean Coach, Altarum Institute.

Graban provides a helpful translation of the terms, practices, and tools of Lean thinking into hospitals’ everyday situations and challenges. His book illustrates Lean’s elements with many actual examples of Lean applications in typical hospital practices and procedures. Graban’s book should definitely be on the reading list for those who want to bring the benefits of lean thinking to healthcare.
—David Mann, Principal, David Mann Lean Consulting

Lean health care is becoming a global movement. The reasons given are overrun costs, errors that compromise patient safety, time of patients wasted, and general bureaucratic inefficiency. In Lean terms the problem is how to eliminate waste. Health care is different than car making. This is true but many, many hospitals are finding the principles of the Toyota Production System apply well and are making remarkable improvements. Unfortunately the remarkable improvements are in specific areas and challenging to sustain because of a mysterious ingredient which the folks at Toyota seem to understand quite well--humans. The humans that health care exists to help also operate the system and are far from perfect. Toyota's system is actually designed to support the development of people, not to provide a quick fix set of technical solutions, and this takes time and patience. Many health care consultants have rebadged themselves as lean consultants and do not understand the real thinking behind the Toyota Production System. Mark Graban is an exception. He has worked hard to study the philosophy and stay true to the thinking of Toyota. His book is a welcome translation of the Toyota Production System into language any health care professional can understand.
—Professor Jeffrey K. Liker, University of Michigan & Bestselling Author of The Toyota Way


Product Details

  • Paperback: 268 pages
  • Publisher: Productivity Press; 2 edition (November 7, 2011)
  • Language: English
  • ISBN-10: 1439870438
  • ISBN-13: 978-1439870433
  • Product Dimensions: 9.8 x 6.9 x 0.8 inches
  • Shipping Weight: 1 pounds (View shipping rates and policies)
  • Average Customer Review: 4.8 out of 5 stars  See all reviews (24 customer reviews)
  • Amazon Best Sellers Rank: #112,037 in Books (See Top 100 in Books)

More About the Author

Mark Graban is a consultant, author, keynote speaker, and blogger in the field of "Lean Healthcare." In June 2011, Mark joined the software company KaiNexus as their "Chief Improvement Officer," to help further their mission of "making improvement easier" in healthcare organizations, while continuing his other consulting and speaking activities.

He is the author of the book Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction (Productivity Press), which was selected for a 2009 Shingo Research and Professional Publication Award and is being translated into six languages. A 2nd revised edition was released in November, 2011. Mark is also currently co-authoring a new book, titled "Healthcare Kaizen: Engaging Front-Line Staff in Sustainable Continuous Improvements," to be released in 2012. He is the founder and lead blogger and podcaster at LeanBlog.org, started in January 2005.

Mark earned a BS in Industrial Engineering from Northwestern University as well as an MS in Mechanical Engineering and an MBA from the MIT Sloan Leaders for Global Operations Program (previously known as Leaders for Manufacturing). Mark has worked in automotive (General Motors), the PC industry (Dell), and industrial products (Honeywell). At Honeywell, Mark was certified as a "Lean Expert" (Lean Black Belt).

Since August 2005, Mark has worked exclusively in healthcare, where he has coached lean teams at client sites in North America and the United Kingdom, including medical laboratories, hospitals, and primary care clinics. Mark's motivation is to apply Lean and Toyota Production System principles to improve quality of care and patient safety, to improve the customer/patient experience, to help the development of medical professionals and employees, and to help build strong organizations for the long term.

In from June 2009 to June 2011, Mark was a Senior Fellow with the Lean Enterprise Institute, a not-for-profit educational organization that is a leading voice in the Lean world. Mark served as the LEI's "Chief Engineer" for healthcare activities, including workshops, web & social media, and other publications. Mark also served as the Director of Communication & Technology for the Healthcare Value Network, a collaboration of healthcare organizations from across North America, a partnership between LEI and the ThedaCare Center for Healthcare Value. Mark continues as an LEI faculty member.

Mark is a popular speaker at conferences and private healthcare meetings. He has guest lectured at schools including MIT and Wharton and has served as a faculty member for the Institute for Healthcare Improvement. He has been quoted and interviewed in many publications, including Health Affairs and the New York Times.

Customer Reviews

Most Helpful Customer Reviews
23 of 26 people found the following review helpful
By Michael
Format:Paperback|Amazon Verified Purchase
I have been reading Lean for a year since I came across it in my MBA program. In my opinion, it is the very best way to fix what ails hospitals. I have visited two of the leaders in the field including Virginia Mason Hospital in Seattle and a ThedaCare Lean event in Wisconsin. I am an experienced Critical Care Physician. This book puts it all together. The author, although an engineer, GETS healthcare. This book is for those of you who have worked long and hard in the trenches of clinical work in hospitals.

The author explains Lean clearly and concisely, and applies the material to hospital functions. Lean teaches that those closest to the work are most able to fashion the processes of the work. In hospitals those closest to the work are the best trained and often the most intelligent. Who better to change the culture. The author minces no words when discussing the difficulties and challenges of attaining such a cultural change. Lean is the only visible way out of the problems of cost, quality, professional and patient satisfaction that have plagued our industry. Lean makes it clear that all these goals are not only attainable, but dependent on one another.

The book is easy to read. It is not dense. I was able to read it in my flight back and forth to Wisconsin. If you are at all interested in hospital quality initiatives or Lean healthcare, you should read this book.
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19 of 22 people found the following review helpful
Format:Paperback
At first, I thought, "this is another Lean Simplified book with hospital words" - lean concept after concept with extensive commentary. This isn't criticism of author Mark Graban, it is what I have come to expect of these days with Lean books. It seems everyone re-publishes the same thing about Lean, except the authors use the "Lean ___insert your industry technical jargon here___," approach.

Here in Lean Hospitals, we have a truly unique experience. I had to read this twice, because I was gliding through this like it was another lexicon remix. This caused me to miss the deeper insight that the author, Mark Graban, artfully inserts in example after example. Once I slowed my pace, Graban very quickly takes you deep into thought provoking examples about the healthcare industry - pushing the reader beyond the common Lean definitions and into the real world. How refreshing! No made up stories in somebody's garden or garage or a skip-hop-and-a-jump through imaginary utopias; NO - Lean Hospitals is the real world application of lean with all of its successes and many lessons learned.

Jammed full of knowledge, testimonials, how-to examples, pictures and illustrations for anyone wondering how Lean could possibly apply to a hospital environment, this book follows a similar pattern of other well written Lean related books where a concept is presented, explanation of the concept is offered and then a host of examples follow to cement the concept in practical application. The real strength of this book is in unique adaptations of kanban and lean concepts which should give some hospital administrators the confidence to take that first step in an otherwise uncertain Lean journey. Bottom line: order several copies and organize a book/work study group with your staff, working out real problems as you make your way through the book. Hint: take your time.

Mark Graban, who has extensive experience in Lean Healthcare implementations, diplomatically chips away on the mainstream approach to 5S - housekeeping - something I have blogged harshly on for over a year now. He stresses the importance of taking 5S out of the narrow crawlspace of housekeeping and into the infinite world of daily idea generation, involvement and continuous improvement. My only criticism here, if you could call it that, is that we only get a glimpse of this alternate 5S universe for a brief period. My neediness aside, this book is unique; non-Japanese AND goes beyond what we know as 5S conventional lean approaches. Mark shows us how hospitals are adopting lean and adapting to their unique environment, the ultimate lesson we should all learn. This is not only rare but refreshing for those of us that have struggled with the way 5S and Lean was interpreted over twenty five years ago and subsequently (and superficially) taught to thousands over the decades. Kudos Mark, for daring to go there, but on this matter - I was hoping you opted for a surgical grade bonesaw instead of a scalpel!

Mark touches briefly on TWI and in particular Job Instruction while you are knee deep in the Standard Work for Hospitals section. Here Mark draws a clear picture of the need for Job Instruction in order for Standard Work to be useful on a daily basis. I believe that this is the only book I have seen that explains the need in a non-manufacturing setting - again, illustrating how hospitals can and are adopting and adapting lean concepts to a real world environment. This may be a good opportunity for readers to point other Lean/TWI skeptics to a real world example of how JI is an elemental skill for Lean leaders. Even more so, TWI and Lean zealots alike will see how this book is substantial, should be taken seriously, and certainly not a Lean "___insert your industry here___" book.

In a previous book review of Managing to Learn, I reveal how John Shook presents a new "pull based authority" concept. In Lean Hospitals, Graban shows us how pull based authority is applied across hospital departments - here we get clear insight on the kanban "how-to" and the reasons why we should consider this approach in administrative situations. It is very important and worth every penny for this chapter alone. This and many other sections of the book take complex Lean concepts and present them simply and clearly for anyone at any level in a hospital setting.

Lean Hospitals is a great book, loaded with how-to and sharp insight that predicts the future of healthcare; those organizations that run business as usual and those that are customer-oriented. The style is straightforward - concepts backed up with know-how, but may require another read to fully grasp the full context. This is because the examples tend to chop up the flow of the concepts and I found myself going back a couple of times to tie it all together. Regardless of my minor observations, keep this fantastic reference handy; I have pulled it off the bookshelf several times already and I work in consumer goods manufacturing, so it should be extremely useful to anyone in a hospital setting.
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11 of 13 people found the following review helpful
Waiting for a long time September 14, 2008
Format:Paperback
Lean Hospitals is a book I have been waiting to be written since 2004 when I first began teaching Lean to healthcare professionals. I just wish I had it four years ago. The book is fast read and does a nice job bridging Lean concepts and principles into the healthcare environment through examples and stories. Additionally, the book does not just focus on the tools Lean, but also the management system. This is a prerequisite for me before I will purchase any book to share with my senior leadership team (I just ordered a copy for the entire team).
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Most Recent Customer Reviews
More than a book, it is a GPS for the quest in healthcare excellence
Mark has probably done more service in bringing sustainable excellence in health care operations than most people realize. Read more
Published 3 months ago by Vinod Parthasaratky
A "Heads Up" on what to expect!
This is a "must read" for any exec healthcare team thinking about implementing lean in their organization. Read more
Published 3 months ago by triche
A Must Read For All Lean and Healthcare Professionals
I have applied lean concepts in manufacturing environments for over 25 years and recently, I started working with hospitals and health clinics. Read more
Published 6 months ago by nTakt, Inc
It will open your eyes!
An excellent read. This edition provides enhanced ideas and recommnedations on the original, the examples Mark uses are real world and applicable - they make you think. Read more
Published 6 months ago by Rich D
Lean Times
This order was received in record time and in perfect condition. This book has become very useful and nessasary in our current iniatives with HCAHPS and Patient Satisfaction.
Published 16 months ago by chelra
A must read book for anyone in healthcare!
I first came across Mark Graban's blog ([...]) where he offers a free download of the 1st chapter of his book. I was immediately hooked! Read more
Published on May 17, 2010 by Cat
Help Improve Hospitals!
Mark Graban's "Lean Hospitals" is a must-read for any hospital going through a Lean transformation. I recommend it for all staff and not just leadership. Read more
Published on May 13, 2010 by Brian R. Buck
The best book for lean healthcare - but some rehash of other lean
It's inevitable, as with any lean book on a specific industry, that 60%+ is a rehash of the typical lean books. Read more
Published on May 5, 2010 by Jason Stokes
Perfect place to start a lean journey
Mark Graban's book is truly a great place to start if you are new to lean or if you are a seasoned lead expert looking at how to apply lean to Hospitals. Read more
Published on February 7, 2010 by Ankit
Great for general lean too!
If you want to learn about how to make improvements in a company or hospital or just further enhance your grasp of lean and broaden your perspective, I would highly recommend Lean... Read more
Published on January 11, 2010 by Chris Waldorf
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