Customer Reviews

Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction

5 star:		(18)
4 star:		(2)
3 star:		(1)
2 star:		(0)
1 star:		(0)

 

 

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.

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.

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).

If you're interested in improving healthcare quality and creating an efficient industry operated by fulfilled caregivers, this book is a must-read. It's easy to digest, while still being thorough. One of its key strengths is that Mark stays true to the Toyota Production System at a time when some are attempting to create their own brand of Lean Healthcare, which perpetuates the myth that management models borne in industry can't possibly apply to healthcare.

Mark writes with amazing clarity and his many anecdotes are helpful in demonstrating how the principles can be put into use. The sections on 5S, work standardization, and error-proofing are particularly strong.

Another of the book's strengths are the "Points to Ponder" at the end of each chapter. I recommend leadership teams develop a reading group approach where they discuss these insightful and sometimes provocative questions. Most healthcare entities have a long way to go to become "learning organizations," but this book is a great way to begin the transformation process. It's now required reading for the leadership teams at all of my healthcare clients.

I noticed that a few of the reviews criticize the book for not being practical enough. But I don't believe Lean Hospitals was intended as detailed how-to book. Rather, it provides an excellent overview of the philosophy and seeks to establish in the reader the necessary mental framework for a successful Lean journey.

It's inevitable, as with any lean book on a specific industry, that 60%+ is a rehash of the typical lean books. If you're already an experienced lean deployment person, you may not get a lot from lean hospitals. For the average joe working at the hospital without any lean experience, however, this book should be read over and over.

I really liked:
- The many examples given in the book, including stories, pictures, and anecdotes
- The focus on all the main pillars of TPS (Toyota Production System) lean
- The constant focus on tradeoffs, and the understanding that healthcare does differ from manufacturing.

I didn't like:
- It was a rehash of other lean books in most ways. I've read this before.

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. The book gives great ideas on where to start lean and how to start lean in a hospital but you still need lean experts to help implement and manage the day to day process.

I am a consultant and have used this book to to help apply lean to other similar places in healthcare like medical practices, dental offices, and veterinary clinics. This book is a must read if you are using lean in any healthcare aspect.

Ankit

Whether you are new to lean thinking or are an experienced practitioner, Mark Graban's book will raise and answer important questions. The book is highly readable and provides enough detail and examples of lean as it is being applied in healthcare without losing the reader in jargon.

I recommend it for all hospitals and healthcare professionals, whether they are enthusiastic about lean or skeptical. We are all consumers of healthcare, a service whose cost and quality need to be improved dramatically. This book offers light towards a path to do this.

This book provides an introduction to lean methodology and how it might apply in a healthcare environment. It is presented in an easy to read format but doesn't really tell you how you might go about introducing lean in your own hospital.

Too many believe that "Lean" is a manufacturing technology. Mark Graban's well written book clearly demonstrates how Lean principles can be extended to service industries such as healthcare. Everyone benefits from performing tasks more efficiently, which is absolutely essential in healthcare where demand is increasing and the number of healthcare workers is often decreasing. Mark demonstrates how each hospital can improve through value stream analysis, kanban, mistake-proofing, flow, and 5S, among other Toyota Production System methods. This is truly a great contribution to the healthcare profession!

I have applied lean concepts in manufacturing environments for over 25 years and recently, I started working with hospitals and health clinics. Lean Hospitals, by Mark Graban has been a valuable resource during my lean healthcare journey.

Initially, I read it to gain a better understanding the differences between implementing lean in hospitals as compared to manufacturing. Now, I use it as a resource and recommend it to healthcare professionals who need an overview of the lean healthcare mindset along with some basic examples and opportunities for success.

It is written in a practical and down to earth style with great examples. For those of us who like to reflect on what we just read, each chapter has a summary, lean lessons, and points to ponder. This book is a great training tool.

Lean Hospitals is must read for all lean professionals especially those initiating projects in healthcare.