Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction (Paperback)

~ (Author)
Key Phrases: improving flow, lean thinking, lean manufacturing environment, Lean Hospitals, New York, Toyota Production System (more...)

Editorial Reviews

Review

The lean approach to healthcare, including a strong emphasis on culture, is the best way to ensure that we care for our patients in the very best way possible. Lean Hospitals emphasizes not only the 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 Medical Center, Dallas, Professor of Pathology, UT Southwestern Medical School

Coupled with a foundation of alignment and accountability, the ideas in this book provide a powerful tool to help hospitals get closer to the goal we want – perfect care.
— Quint Studer, CEO, The Studer Group, author of Results that Last

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

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, manager, Lean Management + O.D, Steelcase, Inc., author of Creating a Lean Culture

Lean healthcare is becoming a global movement. The reasons given are overrun costs, errors that compromise patient safety, wasted time for patients, and general bureaucratic inefficiency. In lean terms, the problem is how to eliminate waste. Healthcare 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 healthcare exists to help also operate the system and are far from perfect. Toyotas system is actually designed to support the development of people, not to provide quick-fix technical solutions, and this takes time and patience. Many healthcare 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 healthcare professional can understand.
— Jeffrey K. Liker, University of Michigan, author of The Toyota Way

Mark Graban is the consummate translator of the vernacular of the Toyota Production System into the everyday parlance of healthcare. With each concept and its application, the reader is challenged to consider what is truly possible in the delivery of healthcare if standarized 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

Mark Graban’s book has documented what is now happening in hospitals all across America as we learn to apply the Toyota Production System methodology to healthcare. This book lays out the nuts and bolts of the lean methodology and also describes the more difficult challenges, which have to do with managing change. Graban’s book is full of wins --- these are the same type of wins that are happening at ThedaCare every day. I wish I could have read this book six years ago, as it might have prevented some of the mistakes we made in our lean transformation journey.
— John S. Toussaint, MD, President/CEO ThedaCare Center for Healthcare Value

Mark Graban’s work has been a steady companion in the three years I have been studying and applying lean in healthcare. He has an accurate sense of how things work in health systems, and he brings a patient-centered perspective that makes me want to do more for the people we serve.
— Ted Eytan, MD, Medical Director, Health Informatics & Web Services

The concepts outlined in this book are the most powerful tools that I have ever encountered to foster innovation, ownership, and accountability at the frontline staff level. This is a must-read for any leader in today’s increasingly complex healthcare industry.
— Brett Lee, PhD, FACHE, Vice President, Children’s Medical Center Dallas

The medical community has a tremendous opportunity to learn methods and techniques to improve the quality and efficiency of care and reduce costs, while at the same time engaging staff in these efforts. Mark Graban has deep experience applying lean in the healthcare field; in his book, he provides an outline of how to transfer concepts originally developed in manufacturing into the unique environment of medical care. Don’t miss the opportunity to learn and apply some great ideas in your organization.
— David Meier, co-author of the bestselling books, The Toyota Way Fieldbook and Toyota Talent

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 payers.
— Steven Spear, Senior Lecturer, MIT, Senior Fellow, IHI

Ít’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, Lean Improvement Specialist, Iowa Health System

Product Description

Winner of a 2009 Shingo Research and Professional Publication Prize. Drawing on his years of working with hospitals, Mark Graban explains why and how Lean can be used to improve safety, quality, and efficiency in a healthcare setting. After highlighting the benefits of Lean methods for patients, employees, physicians, and the hospital itself, he explains how Lean manufacturing staples such as Value Stream Mapping and process observation can help hospital personnel identify and eliminate waste in their own processes, effectively preventing delays for patients, reducing wasted motion for caregivers, and improving the quality of care.

Additionally, Graban describes how Standardized Work and error-proofing can prevent common hospital errors and details root cause problem-solving and daily improvement processes that can engage all personnel in systemic improvement. A unique guide for healthcare professionals, this book clearly elaborates the steps they can take to begin the proactive process of Lean implementation.

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Product Details

• Paperback: 280 pages
• Publisher: Productivity Press; 1 edition (July 24, 2008)
• Language: English
• ISBN-10: 1420083805
• ISBN-13: 978-1420083804
• Product Dimensions: 9.8 x 7 x 0.7 inches
• Shipping Weight: 1.2 pounds (View shipping rates and policies)
• Average Customer Review: 4.8 out of 5 stars  See all reviews (13 customer reviews)
• Amazon.com Sales Rank: #26,891 in Books (See Bestsellers in Books)

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Customer Reviews

Most Helpful Customer Reviews

8 of 8 people found the following review helpful:

5.0 out of 5 stars Best Lean Book for Health Care, October 8, 2008

By	Michael Lieber (Santa Monica, CA USA) - See all my reviews (REAL NAME)

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.

6 of 6 people found the following review helpful:

5.0 out of 5 stars Lean Book Worth Reading Twice! , February 4, 2009

By	Bryan Lund "TWI Blog" (Saint Albans, VT) - See all my reviews (REAL NAME)

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.

6 of 6 people found the following review helpful:

5.0 out of 5 stars Waiting for a long time, September 14, 2008

By	Lee D. Fried - See all my reviews (REAL NAME)

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).