FREE USPS shipping available to all U.S. customers.
MOTM Photo

Management on the Mend

The Healthcare Executive Guide to System Transformation

By: John Toussaint, MD


FREE Shipping

Learn How to Build Leadership Skills In Your Healthcare Team

In stock


Product Description

If you are looking to introduce principle-based leadership in your hospital, your leadership should read Management on the Mend.

Worldwide, the best healthcare organizations have senior managers who lead by example at the front lines of care, delivering better healthcare in an era of continuous change and ever-increasing expectations. These thriving healthcare systems also engage staff at every level to solve problems and embrace change.

John Toussaint, MD, who in his seminal book On the Mend chronicled how a large cradle-to-grave health system revolutionized the way care is delivered, now addresses how healthcare organizations everywhere can successfully transition to lean healthcare, creating better value for patients while eliminating waste from the system.

Management on the Mend: The Healthcare Executive Guide to System Transformation details a model for lean transformation that shows leaders how to embrace an operating and management system that accomplishes the reciprocal goals of a) empowering all frontline caregivers to practice medicine while finding and solving problems and b) empowering all managers and executives to support the work of the frontline caregivers.

“Achieving these dual goals requires a complete cultural transformation,” notes Dr. Toussaint. He explains, “Fundamentally, the two jobs available in a lean organization are a problem solver and problem solver support staff. Most healthcare organizations could not look more different from this lean model.”

Through the lens of 11 diverse organizations, Management on the Mend illustrates how the following essential steps transform healthcare organizations into lean organizations:

  • Laying the foundation by doing the vital pre-work of establishing, understanding, and admitting that change is necessary both organizationally and personally
  • Building a model cell, an area where lean thinking and organizational resources create a mission-critical transformation that can be used as a demonstration and teaching tool for the rest of the organization
  • Establishing the organization-wide values and principles that will guide the work
  • Creating a central improvement office
  • Redesigning the frontline management system
  • Spreading the work throughout the system
  • Realigning the organization’s people, policies, and practices to support this work
  • Overcoming barriers such as medical education programs that churn out individuals rather than team players, the lack of publicly available outcomes data for quality and cost, and perverse payment incentives

Reflecting the flaws and triumphs of the many dozens of healthcare organizations around the world the author has studied and assisted, Management on the Mend is the story of many journeys and one conclusion: lean healthcare is not only possible, it’s necessary.

Start a Book Club with this Study Guide

Dr. Toussaint’s work on lean transformation has been featured in the Wall Street Journal, Harvard Business Review, Health Affairs, and more.

-Health Affairs Blog –The Toyota Production System: What Does It Mean, And What Does It Mean For Health Care
American Association of Physician Leadership Blog Part I: Mending Management: Improving Customer Value By Transforming Operations
American Association of Physician Leadership Blog Part II:  Mending Management: Improving Customer Value By Transforming Operations
-Accountable Care News – The Transformation House
-Lean Post – A Principles-Based Approach to Changing Healthcare Management
-Plant Lean Blog – System Wide Lean Healthcare Transformation
-Health Affairs Blog – A new Framework for Health Care Management
-Harvard Business Review, November 2014 – Hospitals Are Finally Starting to Put Real-Time Data to Use
-Harvard Business Review, October 2015 – Hospitals Can’t Improve without Better Management Systems
-Harvard Business Review, December 2015 – To Radically Redesign Health Care, Start with One Unit
-Lean Blog Podcast – Management on the Mend
-Huffington Post – A Watershed Moment that will turn around the VA
-Journal of Healthcare Management – A Rapidly Adaptable Management System
-Journal of Healthcare Management – The Framework for a Whole-System Transformation
-Becker’s Hospital Review – The Model Cell
-Blogs by Paul DeChant,  Gene Lindsey  Karen Martin

Purchase on Amazon Kindle 

Volume discounts available

Download Appendix Figures from Management on the Mend



  1. —Rick Wartzman, executive director of the Drucker Institute and Fortune columnist

    (verified owner):

    Management on the Mend is a supremely well-written, fast-moving, example-filled guide to transforming healthcare organizations. But the truth is the book should be required reading for any executive trying to radically improve the way his or her company operates. John Toussaint’s lessons are so cogent and so powerful they transcend any one field.

  2. —Peter Ward, Richard M. Ross Chair in Management, Ohio State University

    (verified owner):

    Management on the Mend is a playbook for healthcare leaders seeking to transform their organizations. Drawing on the experiences of the most successful healthcare transformations to date, the book describes the ‘how’s and whys’ of the decisions required to achieve transformation. More important, it provides options that have been shown to work under different circumstances. A must- read for healthcare leaders concerned with delivering value based on cost, safety, and patient experience.

  3. —Stephen M. Shortell, PhD, MPH, MBA, dean emeritus, Haas School of Business, UC-Berkeley

    (verified owner):

    Management on the Mend goes beyond the techniques and tools to provide a road map for transforming the entire organization. Concrete, rich examples are provided to help healthcare leaders create new organizations that can sustain consistent improvements in care on a daily basis. Essential reading for all who recognize the need to go beyond their own personal and their organization’s comfort zone.

  4. —Leonard Berry, PhD, coauthor, Management Lessons from Mayo Clinic

    (verified owner):

    An honest, wise, practical, and inspiring book from a healthcare leader who lives what he teaches.

  5. —James Hereford, COO, Stanford Hospital & Clinics

    (verified owner):

    This is a critical read for any healthcare leader who is contemplating his or her own lean journey and, frankly, for any healthcare executive who is trying to understand how he or she needs to position his or her organization for success in the future.