In 2001, Virginia Mason Medical Center Chairman and CEO Gary S. Kaplan, MD, FACP, FACMPE, introduced the Virginia Mason Production System, a strategy of continuous process improvement based on Toyota's manufacturing principles of waste elimination. Now, after approximately 10 years, the system has seen huge success in patient safety, direct patient care time and revenue cycle, among other areas. For example, patient falls were reduced from 3.33 falls per 1,000 patient days in 2006 to 2.33 in 2010, according to the health system.
As other initiatives to improve safety and lower costs have come and gone, VMPS is impressive not only in its success rate, but also in its longevity. What is the secret to its success? Steve Schaefer, the vice president of finance, and John Donnelly, the administrative director of supply chain at Virginia Mason, describe how VMPS has changed the hospital's culture and how it is affecting all areas of the organization, including supply chain.
Hospital culture
One of the keys to VMPS' success is how Virginia Mason's leadership creates a hospital culture that emphasizes collaboration and respect for people, according to Mr. Schaefer and Mr. Donnelly. "From the CEO to the CFO and COO to vice presidents and directors, there is mutual accountability that requires us all to be engaged in this work in all the various areas that we lead," Mr. Schaefer says. VMPS requires everyone identify and eliminate waste in processes in order to increase their value. This shift in how the hospital operated was not easy, however. The commitment of leadership to a new system of analyzing and improving processes in the hospital was essential for getting the buy-in of staff and physicians, according to Mr. Schaefer and Mr. Donnelly. "We kept waiting for leadership to flinch, because at first we thought it was just another management thing. But they didn't waver," Mr. Schaefer says.
Frontline workers
While hospital leaders were integral to gaining buy-in and driving the culture change, the real work under VMPS comes from the frontline workers. "Culturally, it started from the top down, but our objective is to see this really as a grass roots effort at wanting change coming from the frontline staff," Mr. Schaefer says. For example, hospital nursing staff and supply chain staff jointly developed a method for preventing missing supplies. Each supply has two bins; when one bin is in use it signals the supply chain staff to replenish the bin, Mr. Donnelly says. This change in the resupplying process created a visual cue for replenishment and helped reduce the number of calls from the OR to central supply due to missing supplies or other problems by 94 percent.
Partnerships
In addition to partnerships between departments within the hospital, Virginia Mason has extended its production system to a partnership with another organization. The health system is partnered with its medical supply distributor Owens & Minor to eliminate waste in supply chain.
"Most organizations have a relationship with their vendors that is often a source of conflict," Mr. Donnelly says. "When we started working with Owens & Minor, we started working cooperatively. We created a model where defects and rework were put into a joint report. It didn't matter who had the defect, we pursued the root cause of the defects together and didn't blame each other. [This] was the source of creating efficiencies," he says.
Virginia Mason has a "just in time" system of supply acquisition. "We don't have a warehouse," Mr. Donnelly says. "We rely on Owens & Minor to be our warehouse." The hospital was able to reduce supply inventory and space.
Learn more about the Virginia Mason Production System.
"Nut Island Effect": The Challenges of Hospital Leadership
A Lean Machine: How Lean Methodology Can Streamline OR Processes
As other initiatives to improve safety and lower costs have come and gone, VMPS is impressive not only in its success rate, but also in its longevity. What is the secret to its success? Steve Schaefer, the vice president of finance, and John Donnelly, the administrative director of supply chain at Virginia Mason, describe how VMPS has changed the hospital's culture and how it is affecting all areas of the organization, including supply chain.
Hospital culture
One of the keys to VMPS' success is how Virginia Mason's leadership creates a hospital culture that emphasizes collaboration and respect for people, according to Mr. Schaefer and Mr. Donnelly. "From the CEO to the CFO and COO to vice presidents and directors, there is mutual accountability that requires us all to be engaged in this work in all the various areas that we lead," Mr. Schaefer says. VMPS requires everyone identify and eliminate waste in processes in order to increase their value. This shift in how the hospital operated was not easy, however. The commitment of leadership to a new system of analyzing and improving processes in the hospital was essential for getting the buy-in of staff and physicians, according to Mr. Schaefer and Mr. Donnelly. "We kept waiting for leadership to flinch, because at first we thought it was just another management thing. But they didn't waver," Mr. Schaefer says.
Frontline workers
While hospital leaders were integral to gaining buy-in and driving the culture change, the real work under VMPS comes from the frontline workers. "Culturally, it started from the top down, but our objective is to see this really as a grass roots effort at wanting change coming from the frontline staff," Mr. Schaefer says. For example, hospital nursing staff and supply chain staff jointly developed a method for preventing missing supplies. Each supply has two bins; when one bin is in use it signals the supply chain staff to replenish the bin, Mr. Donnelly says. This change in the resupplying process created a visual cue for replenishment and helped reduce the number of calls from the OR to central supply due to missing supplies or other problems by 94 percent.
Partnerships
In addition to partnerships between departments within the hospital, Virginia Mason has extended its production system to a partnership with another organization. The health system is partnered with its medical supply distributor Owens & Minor to eliminate waste in supply chain.
"Most organizations have a relationship with their vendors that is often a source of conflict," Mr. Donnelly says. "When we started working with Owens & Minor, we started working cooperatively. We created a model where defects and rework were put into a joint report. It didn't matter who had the defect, we pursued the root cause of the defects together and didn't blame each other. [This] was the source of creating efficiencies," he says.
Virginia Mason has a "just in time" system of supply acquisition. "We don't have a warehouse," Mr. Donnelly says. "We rely on Owens & Minor to be our warehouse." The hospital was able to reduce supply inventory and space.
Learn more about the Virginia Mason Production System.
Related Articles on Lean Manufacturing:
What Continuous Improvement Looks Like in a Hospital OR: Lean at ThedaCare"Nut Island Effect": The Challenges of Hospital Leadership
A Lean Machine: How Lean Methodology Can Streamline OR Processes