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Transforming Health Care: Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience [Hardcover]

Charles Kenney , Donald M. Berwick
4.6 out of 5 stars  See all reviews (19 customer reviews)

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Book Description

November 8, 2010 1563273756 978-1563273759 1st

For decades, the manufacturing industry has employed the Toyota Production System — the most powerful production method in the world — to reduce waste, improve quality, reduce defects and increase worker productivity. In 2001, Virginia Mason Medical Center, an integrated healthcare delivery system in Seattle, Washington set out to achieve its compelling vision to become The Quality Leader and to fulfill that vision, adopted the Toyota Production System as its management method.

Winner of the Shingo Research and Professional Publication Award!

Transforming Health Care: Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience takes you on the journey of of Virginia Mason Medical Center's pursuit of the perfect patient experience through the application of lean principles, tools, and methodology. The results speak for themselves, including:

  • An innovative patient safety alert system
  • Reduction in professional liability insurance expenses
  • Foundational changes that make it possible for nurses to spend 90% of their time with patients
  • A computerized module that sorts through electronic medical charts and automatically identifies when disease management and preventative testing due

Over the last several years Virginia Mason has become internationally known for its journey towards perfection by applying the Toyota Production System to healthcare. The book takes readers step by step through Virginia Mason's journey as it seeks to provide perfection to its customer – the patient. This book shows you how you use this system to transform your own organization.

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Transforming Health Care: Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience + Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement, Second Edition + Lean Six Sigma for Hospitals: Simple Steps to Fast, Affordable, and Flawless Healthcare
Price for all three: $115.43

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Editorial Reviews


If you work in the health and medical care field and you believe you and your institution are as good as it is possible to be, you should read this book. It will reset your standards and show you how to produce more value for your patients at a lower cost. This is a front line story, not a pie in the sky theory or project of the month. It is a story about real people dedicated to the pursuit of habitual excellence.
—Paul O’Neill, 72nd Secretary of the U.S. Treasury & former Chairman and CEO of Alcoa

A comprehensive and insightful book that chronicles an arduous journey to achieve an exceptional patient-centered culture using a management system only now recognized as relevant to health care. This is a story of how Virginia Mason became the benchmark against which other health care systems must judge themselves, and a beacon in a field that has resisted change for far too long.
—David M. Lawrence, MD, MPH, Chairman and CEO (retired), Kaiser Foundation Health Plan and Hospitals, Inc.

The challenges to our U.S. health care system have never been greater. We are challenged by the high cost of care and less than optimal quality and safety. Virginia Mason Medical Center has been on a ten year journey to demonstrate just what is possible and the results have been profound. What is equally amazing, and must reading for health care leaders, is the story of their journey. It is possible to improve quality and safety while simultaneously reducing cost!
—John Kitzhaber, MD, Governor of Oregon 1995-2003

U.S. health care is replete with stories of failed attempts to improve quality and control soaring costs, only to succumb to perverse incentives, infighting and an entrenched status quo. Virginia Mason offers a different path forward, by showing what happens when all of health care’s stakeholders — doctors, employers, insurers — align themselves behind pursuing the best care for the patient. It’s a potential model precisely because its leadership medical staff had to overcome the same challenges that affect hospitals and clinicians across the country today.
—Vanessa Fuhrmans, The Wall Street Journal

Congratulations to the Virginia Mason team for being another great example of committing to a compelling vision and to continuous quality improvement … . Thank You!
—Alan Mulally, former President and CEO, Boeing Commercial Airplanes; current President and CEO, Ford Motor Company

Health care transformation is a process not an event. This book richly describes this process at Virginia Mason — not just the principles but all the challenges along the way and how they were overcome. It is a textured account of an ongoing journey and as such is an invaluable aid to anyone serious about transforming their own organization.
—Richard Bohmer, MBChB, MPH Professor of Management Practice, Harvard Business School

This is the story of a journey. It’s a journey that began almost a decade ago, that continues today, and that will likely continue for the foreseeable future. Through a number of powerful case studies, this book illustrates how Virginia Mason Medical Center has steadily improved the safety, quality, and efficiency of its patient care — one process at a time. But more importantly, it is a study in leadership and cultural transformation in one of our nation’s most important industries — health care. That transformation has made patient-centered care much more than a slogan at Virginia Mason; it has become a way of doing business, each and every day. The beneficiaries of that transformation, first and foremost, are the patients Virginia Mason serves. But of equal importance is the new-found sense of accomplishment and satisfaction that these changes have engendered among the Medical Center’s physicians, management team and employees. This book is inspiring must reading for anyone who leads, or aspires to lead, any health care organization.
— William F. Jessee, MD, FACMPE, President and CEO, Medical Group Management Association

If you want to understand what health care can become, you need to know about Virginia Mason Medical Center. This book gives you the complete story. It is essential reading.
—David Cutler, former Senior Health Care Advisor, Obama Presidential Campaign

An inspiring tale of leadership, discipline, and persistence by an organization committed to excellence in patient care. VMMC has redefined patient-centeredness as the core of process change. By so doing, not only has it transformed its culture and dramatically improved outcomes, it has set new standards for quality and efficiency. Must reading for all health care leaders who are serious about quality.
—Lucian L. Leape, MD, Harvard School of Public Health

This remarkable story of Virginia Mason's journey to Lean offers hope that America can achieve the high-quality, affordable care we all deserve.
—Ceci Connolly, Freelance Writer

How does a hospital change the very culture of medicine? By abandoning the philosophy that says This is the way we’ve always done it! That’s the essence of the amazing story of true change told by Charles Kenney in Transforming Healthcare: Virginia Mason Medical Center’s Pursuit of the Perfect Patient Experience. But hold on: This is not a cold chronicle of good people moving deck chairs around on the deck of the Titanic. This is genuine course-changing, history-changing work born of steely determination to stop hurting patients by finding ways of practicing medicine that tradition never taught.
How does one transform to an idyllic hospital where errors never hurt patients and people are happy? By breaking the molds and infusing a common vision and by starting down the path Dr. Gary Kaplan and Virginia Mason were courageous enough to blaze ten years ago - when no one else was even peeking outside the box.
If you intend to keep your patients safe - if you intend to improve the working environment, the bottom line, and the camaraderie of your hospital - you cannot ignore this story! This book isn’t about Lean, Toyota, or any single methodology as much as it’s about a refusal to maintain the terrible status quo documented by the Institute of Medicine in 1999. This book is the foundational element of understanding what it takes to really change a moribund culture.
—John J. Nance, author, Why Hospitals Should Fly

Virginia Mason Medical Center is widely recognized as the pioneer in applying the disciplines of the Toyota Production Systems to improve the delivery of health care. Now, with the publication of Transforming Health Care, we have a first-hand account of what they did and what they learned: the steps they took to make the concept of Team Medicine a reality; the struggles and successes in moving from physician-centric to patient-centered care; and the projects they have undertaken to redesign clinical pathways to eliminate waste and error, reduce scientific uncertainty, and promote patient preferences. An easy read, but also an in-depth account of Virginia Mason’s effort to transform itself. This book is a must for students of organizational behavior as well as for those who aspire to improve health care.
—John E. Wennberg, MD, MPH, Peggy Y. Thomson Professor Emeritus (Chair) in the Evaluative Clinical Sciences & Founder and Director Emeritus, The Dartmouth Institute for Health Policy and Clinical Practice

About the Author

Seattle, WA, USA

Product Details

  • Hardcover: 223 pages
  • Publisher: CRC Press; 1st edition (November 8, 2010)
  • Language: English
  • ISBN-10: 1563273756
  • ISBN-13: 978-1563273759
  • Product Dimensions: 9.1 x 6.2 x 0.7 inches
  • Shipping Weight: 1 pounds (View shipping rates and policies)
  • Average Customer Review: 4.6 out of 5 stars  See all reviews (19 customer reviews)
  • Amazon Best Sellers Rank: #100,135 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews
20 of 22 people found the following review helpful
5.0 out of 5 stars How Lean Health Care Transformation Can Work January 3, 2011
Format:Hardcover|Verified Purchase
The more you know about lean transformation the more you'll envy the Virginia Mason Medical Center (VMMC) for having the right people in the right places at the right times. At the end of the 1990s VMMC faced a struggle for survival as an in-the-black, separate entity. The CEO, Gary Kaplan, an MD and highly regarded executive saw the need for dramatic action and found it, after energetic searching, in Toyota Way thinking and acting. He created and nurtured the informed consent of the board of directors and, through John Black, engaged the Japanese consulting firm Shingijutsu. The executive team joined in embracing what became known as the Virginia Mason Production System (VMPS) and, with the clinical staff, hammered out the Virgina Mason Medical Center Physician Compact, the basis for concordant action in the VMPS.

What's really to envy is the constancy of purpose that VMMC has maintained: when transformation efforts flagged or failed or worse - and they did, regularly - execs and docs, with board support, doubled-down and solved the problems. Each time that happened momentum increased: physicians saw better outcomes and less wasted effort, patients had better experiences, nurses spent more time actually helping patients, payers got to spend money where it mattered more, medical errors (and malpractice insurance cost) dropped dramatically, the list goes on and on, each recovered success synergizing more successes.
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5 of 6 people found the following review helpful
5.0 out of 5 stars Transforming Health Care April 23, 2011
By DavidO
Format:Hardcover|Verified Purchase
"If it was easy, anybody could do it..." The story of the "pursuit of the perfect patient experience" by the people of VMMC is truly an inspiration that calls each of us again to the pursuit of excellence in our leadership and service in health care. This well-written story provides us information for our heads and inspiration for our hearts. It shows us with a substantial real-world example that we can do profoundly better when we wholeheartedly pursue excellence in patient-focused care in a committed, collaborative and creative manner. The ongoing story of the pursuit of extraordinary service to people by the people of VMMC is compelling evidence that although it is not easy, it is the right thing to do, and we can do it, too. "It is the stories we tell others and the stories we tell ourselves that determine the quality of our lives." This is a story worth reading, worth telling, and worth living.
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1 of 1 people found the following review helpful
5.0 out of 5 stars outstanding February 13, 2014
Format:Kindle Edition|Verified Purchase
Outstanding work. A model for all health care organizations world wide. We'll written and comprehensive. Emphasis on patient safety and patient we'll being
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3 of 4 people found the following review helpful
5.0 out of 5 stars Hands down, the best book on Lean implementation! July 19, 2012
By Wes
Format:Kindle Edition|Verified Purchase
I've read all the classic Lean books but nothing compares to this. It's written from the perspective of Dr. Kaplan and his leadership team and they share not only the success stories but the hard lessons learned on their journey to Lean. If you're a Lean practitioner, don't get put off by the fact that VM is in health care. This book applies across all industries.
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5 of 7 people found the following review helpful
4.0 out of 5 stars Good read for the hospital improvement novice or sensei January 12, 2011
Format:Hardcover|Verified Purchase
This is a good read for anyone interested in improving operations in American hospitals. It tells the story of a decade long journey at Virginia Mason Medical Center to improve quality and reduce costs by adapting the Toyota Production System to healthcare. It captures successes and struggles and reads like a good history book. Students and readers that are beginning to explore quality improvement will find this very valuable. More experienced readers will recognize that many of the solutions offered are now becoming standard practice in American hospitals. But even for the true quality Sensei, the book still offers a good synthesis of how to tie many quality improvement concepts into a unified management system and how to keep raising the bar higher. I recommend it.
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2 of 3 people found the following review helpful
5.0 out of 5 stars Must-read list! January 2, 2013
Format:Hardcover|Verified Purchase
An inspiring, well written book -- should be on the must-read list for anyone in healthcare today. I had the privilege of meeting the author at an IHI event, and was moved by his passion for this area. An important insight into how systems can make changes towards higher quality healthcare in the US.
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4.0 out of 5 stars nice case study June 8, 2014
By Lineman
Format:Hardcover|Verified Purchase
A good chronicling of Virginia Mason's journey to lean. It illustrates the long and involved history of initial inspiration, learning and the trials and tribulations of converting processes and organizational culture. For those thinking this is an easy course to take, or that it is simply the latest in corporate fads, the case of Virginia Mason will show them otherwise.

The shortcomings of the book, to me anyway, is that it is mostly about the challenge and achievements of organizational change. It was fairly light on what aspects of lean/six sigma worked. I would have liked to read more about specific tools (e.g., VSM, 5 S, heijunka, kanban) and their use. Where were they successful, where did it take several tries, how can we readers learn from your experience. These are mentioned here and there, but insufficiently to help the rest of us in our own journeys.

It is a useful tool for upper management. They may not be interested in the getting into the weeds. but they are interested in the time and devotion it took to change the organization.
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Most Recent Customer Reviews
5.0 out of 5 stars If only all healthcare systems took this to heart
There are a few examples of healthcare systems that provide high quality care and put in place the structures to really support the staff. Read more
Published 1 month ago by Digital Dharma
4.0 out of 5 stars Helpful Starter Book
Quick read- wish there was a bit more detail about the improvement measures, but overall a great book to start learning about improving healthcare using the Toyota system.
Published 6 months ago by JN
3.0 out of 5 stars Will we see this concept soon on the nightly news?
Interesting read, but how it will apply to the overall world of medicine is to be seen. Concept seems very difficult to apply when related to individual lives and complex medical... Read more
Published 7 months ago by James C Lester
4.0 out of 5 stars Virginia Mason Transforms Medical Delivery
The Virginia Mason Health System has a remarkable story of organizational, operational, and cultural change, and this book tells many compelling incidents in the change effort. Read more
Published 8 months ago by J. Scholz
5.0 out of 5 stars Love Virginia Mason
I was working at Virginia Mason when they started this whole lean process so was very into the stories they told. Read more
Published 11 months ago by Kindle Customer
5.0 out of 5 stars Pioneering example that we all can learn from
"Transforming Health Care: Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience" is an important read on the path to healthcare sustainability,... Read more
Published 12 months ago by Russ Emrick
5.0 out of 5 stars If I was 30 years younger
I would move to Seatle and try to get a job at Virginia Mason. What an exciting place to work! It is a vision of the future of health care where the focus is on the patient. Read more
Published 13 months ago by William Davis MD
5.0 out of 5 stars An Innovative Solution at a Challenging Time
Anyone familiar with the current problems in healthcare knows that we still have a long way to go. Virginia Mason had the courage to step into the unknown and adopt the Toyota... Read more
Published 15 months ago by Joseph Merrill
4.0 out of 5 stars Great story
I was very impressed by the dedication of the organization to the idea of the Toyota Production System, to the point of taking a full team to Japan. Read more
Published 17 months ago by Gonzilla
5.0 out of 5 stars Lean is not just for manufacturing!
As a nursing healthcare administrator who was at Virginia Mason when the Toyota Production System (TPS) was first introduced in 2002 and was in the first group of leaders to be... Read more
Published 19 months ago by Dianna Davis
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