Problem-solving. Continuous improvement. Comprehensive engagement from the top down.
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 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.
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